Provider Demographics
NPI:1972560753
Name:HAHN MEDICAL PRACTICES, INC
Entity Type:Organization
Organization Name:HAHN MEDICAL PRACTICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-822-6614
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-4737
Mailing Address - Country:US
Mailing Address - Phone:304-822-6614
Mailing Address - Fax:304-822-7665
Practice Address - Street 1:22347 NORTHWESTERN PIKE
Practice Address - Street 2:EAST SUNRISE PROFESSIONAL BUILDING
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-6343
Practice Address - Country:US
Practice Address - Phone:304-822-3838
Practice Address - Fax:304-822-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15226207NS0135X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001710842OtherWV BLUE SHEILD GROUP
WV0037934000Medicaid
WV0070006000Medicaid
WV9359351Medicare UPIN