Provider Demographics
NPI:1073638482
Name:HASSELBACHER, DAVID ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:HASSELBACHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3430 NEWBURG RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2497
Mailing Address - Country:US
Mailing Address - Phone:502-238-3178
Mailing Address - Fax:502-238-3653
Practice Address - Street 1:4950 NORTON HEALTHCARE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2845
Practice Address - Country:US
Practice Address - Phone:502-614-4179
Practice Address - Fax:502-614-4450
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY40383207QS1201X, 207RC0200X
KY225843207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100005160Medicaid
IN200923480Medicaid
KY1200918Medicare PIN
KYI73017Medicare UPIN
KY0249112Medicare PIN
KY00150008Medicare PIN
KY7100005160Medicaid
KY0791209Medicare PIN
IN258300AMedicare PIN