Healthcare Provider Details

I. General information

NPI: 1144112707
Provider Name (Legal Business Name): MICHAEL G HAHN B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 S SPRING AVE
SAINT LOUIS MO
63110-2520
US

IV. Provider business mailing address

809 N CLEVELAND ST
LITTLE ROCK AR
72205-2903
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-3955
  • Fax:
Mailing address:
  • Phone: 479-685-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: