Individual
HAZAR HASSUNEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-7041
(502) 589-5093
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 852-7041
(502) 589-5093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54079
KY
208000000X
Pediatrics Physician
54079
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100483170
—
KY
Enumeration date
04/07/2016
Last updated
03/01/2021
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