Provider Demographics
NPI:1386921013
Name:JAMES HASSELLE
Entity type:Organization
Organization Name:JAMES HASSELLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:HASSELLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-865-2400
Mailing Address - Street 1:900 MASSACHUSETTS ST
Mailing Address - Street 2:SUITE 408
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2868
Mailing Address - Country:US
Mailing Address - Phone:785-865-2400
Mailing Address - Fax:785-865-0014
Practice Address - Street 1:900 MASSACHUSETTS ST
Practice Address - Street 2:SUITE 408
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2868
Practice Address - Country:US
Practice Address - Phone:785-865-2400
Practice Address - Fax:785-865-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74031364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty