Provider Demographics
NPI:1194864983
Name:HAHN, KURT ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:ROBERT
Last Name:HAHN
Suffix:
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 1:307 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:PA
Mailing Address - Zip Code:18810-1710
Mailing Address - Country:US
Mailing Address - Phone:570-888-4494
Mailing Address - Fax:570-888-7124
Practice Address - Street 1:307 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:PA
Practice Address - Zip Code:18810-1710
Practice Address - Country:US
Practice Address - Phone:570-888-4494
Practice Address - Fax:570-888-7124
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035457E2084P0800X
OH35.0491302084P0800X
NY175222-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C30747Medicare UPIN
PA121481Medicare ID - Type Unspecified