Provider Demographics
NPI:1073556205
Name:HAHN, WILLIAM K JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:HAHN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638269
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:440-816-4930
Mailing Address - Fax:
Practice Address - Street 1:18181 PEARL RD STE B206
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6951
Practice Address - Country:US
Practice Address - Phone:440-816-4930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-065207207V00000X
OH35065207174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH912053394027OtherCARESOURCE
OH000000154795OtherANTHEM
OH0954829Medicaid
OH2329661OtherAETNA MEDICARE SELECT
OH4630823OtherAETNA
OH160050410OtherRAIROAD MEDICARE
OH36D0893232OtherCLIA NUMBER
OH4630823OtherAETNA
OH160050410OtherRAIROAD MEDICARE