Provider Demographics
NPI:1144652033
Name:HAHN, HERBERT BARTON (OD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:BARTON
Last Name:HAHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ANSLEY DR
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-1639
Mailing Address - Country:US
Mailing Address - Phone:706-864-3074
Mailing Address - Fax:706-864-3075
Practice Address - Street 1:134 ANSLEY DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1639
Practice Address - Country:US
Practice Address - Phone:706-864-3074
Practice Address - Fax:706-864-3075
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002780152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist