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NPI Code Detail

MEDICARE: DR. CHRISTOPHER J HASSELTINE M.D.

MEDICARE: DR. CHRISTOPHER J HASSELTINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD426412PA
22084P0800XPsychiatry PhysicianK2034TX
32084P0800XPsychiatry Physician35075689OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
28K5336OTHERTXMEDICARE PTAN
3092745F3FOTHERPAMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205809001
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER J HASSELTINE M.D.
Provider Business Mailing Address
First Line : 5350 LAMME RD
Second Line :
City : MORAINE
State : OH
Zip : 45439-3215
Country : US
Telephone Number : 937-534-4620
Fax Number : 937-522-8799
Provider Business Practice Location Address
First Line : 5350 LAMME RD
Second Line :
City : MORAINE
State : OH
Zip : 45439-3215
Country : US
Telephone Number : 937-534-4620
Fax Number : 937-522-8799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 04/18/2017

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