Basic Information
| Provider Information | |||||||||
| NPI: | 1366653867 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAHN | ||||||||
| FirstName: | JOSEPH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 VALLEY VIEW ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | PETERSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 268479543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042579785 | ||||||||
| FaxNumber: | 3048227665 | ||||||||
| Practice Location | |||||||||
| Address1: | PHYSICIAN OFFICE CENTER | ||||||||
| Address2: | 1 MEDICAL CENTER DRIVE | ||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 26506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042937401 | ||||||||
| FaxNumber: | 3042936963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 21610 | WV | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.