Provider Demographics
NPI:1437969193
Name:HIBBARD, SOLANA MARIA
Entity type:Individual
Prefix:
First Name:SOLANA
Middle Name:MARIA
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 POPLAR LEVEL RD # A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1348
Mailing Address - Country:US
Mailing Address - Phone:870-810-2893
Mailing Address - Fax:
Practice Address - Street 1:2021 JEFFERSONVILLE COMMONS DR
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8996
Practice Address - Country:US
Practice Address - Phone:181-228-2016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05162207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine