Individual
DR. DIANE HIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
635 E. BASELINE RD., PHOENIX, AZ 85042
(602) 243-7277
(602) 243-1235
Mailing address
2702 N. 3RD ST., STE. 4020, PHOENIX, AZ 85004-1130
(602) 323-3242
(602) 323-3496
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
3356
OK
207V00000X
Obstetrics & Gynecology Physician
Primary
4746
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137780A
—
OK
01
—
243326007
MEDICARE
OK
05
—
325004
—
AZ
01
—
90110053
PACIFIC CARE
OK
Enumeration date
06/13/2005
Last updated
07/24/2009
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