Provider Demographics
NPI:1629075932
Name:HAHN, DEBORAH ANN (DO)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:HAHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 W UNION HILLS DR STE 2800B
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1380
Mailing Address - Country:US
Mailing Address - Phone:623-322-4991
Mailing Address - Fax:623-322-9568
Practice Address - Street 1:6320 W UNION HILLS DR STE 2800B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1380
Practice Address - Country:US
Practice Address - Phone:623-322-4991
Practice Address - Fax:623-322-9568
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5469475OtherCCN
AZ55Y6ZJOtherUHC
AZ783747Medicaid
AZPROV000061233OtherSCHALLER ANDERSON
AZ7188444OtherAETNA
AZ81060639685308A003OtherCHAMPUS
AZ895157OtherUSA
AZ2Z0277OtherHEALTH NET
AZ2103587OtherFIRST HEALTH
AZ81060639602OtherPACIFICARE
AZAZ0733960OtherBC/BS
AZ55Y6ZJOtherUHC
AZ81060639685308A003OtherCHAMPUS
AZ895157OtherUSA