Provider Demographics
NPI:1336112788
Name:HASSELL, JAMES A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:HASSELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 850489
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0489
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-631-3361
Practice Address - Street 1:5621 COTTAGE HILL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4210
Practice Address - Country:US
Practice Address - Phone:251-666-2439
Practice Address - Fax:251-666-3166
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13276207Q00000X
ALMD.16116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL101081Medicaid
AL1336112788OtherTRICARE SOUTH
AL510-11274OtherBCBS
AL000089776OtherMEDICAID
AL101080Medicaid
AL510-11279OtherBCBS
AL51089776OtherBCBS
AL101079Medicaid
AL510-11281OtherBCBS
AL510-11282OtherBCBS
AL101078Medicaid
AL000089776OtherMEDICARE
AL510-11281OtherBCBS
AL1336112788OtherTRICARE SOUTH
ALB23337Medicare UPIN