=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124656848
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICHOLAS PAUL HAHN DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2020
-----------------------------------------------------
Last Update Date | 06/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3530 HOUMA BLVD STE 300
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-264-5142
-----------------------------------------------------
Fax | 504-455-2648
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3530 HOUMA BLVD STE 300
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-264-5142
-----------------------------------------------------
Fax | 504-455-2648
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 341211
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------