Individual
KENNETH A HAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1306 HOSPITAL ST, GREENVILLE, MS 38703-3215
(662) 334-9712
(662) 332-9703
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
14817
MS
207RI0011X
Interventional Cardiology Physician
14817
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117699
—
MS
05
—
159492001
—
AR
05
—
1597325
—
LA
01
—
P00314972
RR MEDICARE
—
Enumeration date
08/10/2006
Last updated
05/21/2008
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