Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 40383 | KY |
Y | 207RP1001X | Pulmonary Disease | 225843 | KY |
NPI | 1073638482 |
---|---|
Provider Name | Dr. David Alan Hasselbacher |
First Address | Louisville, KY 40218-2497 |
Second Address | Louisville, KY 40241-2845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200923480 | (05) | IN |
7100005160 | (05) | KY |
I73017 | (02) | KY |