Provider Demographics
NPI:1982993697
Name:HAHN, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
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 1:204 BRIDGEWAY ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IN
Mailing Address - Zip Code:47001-1334
Mailing Address - Country:US
Mailing Address - Phone:812-926-3133
Mailing Address - Fax:812-926-1668
Practice Address - Street 1:1640 FLOSSIE DR
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:IN
Practice Address - Zip Code:47025-8424
Practice Address - Country:US
Practice Address - Phone:855-227-4230
Practice Address - Fax:812-926-1668
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47135208000000X, 2080S0010X
WI57696-20208000000X
OH35.123938208000000X
IN01075376A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine