Provider Demographics
NPI:1922021575
Name:HAHN, RODRICK C (DC)
Entity Type:Individual
Prefix:
First Name:RODRICK
Middle Name:C
Last Name:HAHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 OLD PRESTON HWY N
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-3297
Mailing Address - Country:US
Mailing Address - Phone:502-957-1021
Mailing Address - Fax:502-957-1703
Practice Address - Street 1:1679 OLD PRESTON HWY N
Practice Address - Street 2:SUITE 6
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-3297
Practice Address - Country:US
Practice Address - Phone:502-957-1021
Practice Address - Fax:502-957-1703
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY244548000-2445427000OtherPASSPORT ADVANTAGE
KY000000041631OtherANTHEM
KY5674124OtherCIGNA
KY85002988Medicaid
KYP00154881OtherRAILROAD MEDICARE PIN
KY44-00228OtherUNITED HEALTHCARE
KY2426754OtherAETNA
KYDC2130OtherRAILROAD MEDICARE GROUP #
KY50004038-50004037OtherPASSPORT
KY8907Medicare PIN