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Individual

MRS. SUSAN GAYLE HIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4805 MONTGOMERY RD, STE 410, CINCINNATI, OH 45212
(513) 241-2370
Mailing address
4805 MONTGOMERY RD STE 150, CINCINNATI, OH 45212-2280
(513) 961-5558

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35.138748
OH
2084N0400X
Neurology Physician
46587
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002071450
MEDICARE
WI
05
34552200
WI
Enumeration date
06/12/2006
Last updated
01/21/2022
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