Healthcare Provider Details

I. General information

NPI: 1073638482
Provider Name (Legal Business Name): DAVID ALAN HASSELBACHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 NORTON HEALTHCARE BLVD SUITE 208
LOUISVILLE KY
40241-2845
US

IV. Provider business mailing address

3430 NEWBURG RD SUITE 150
LOUISVILLE KY
40218-2497
US

V. Phone/Fax

Practice location:
  • Phone: 502-614-4179
  • Fax: 502-614-4450
Mailing address:
  • Phone: 502-238-3178
  • Fax: 502-238-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number40383
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number225843
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number40383
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: