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NPI Code Detail

MEDICARE: JONATHAN M PHILPOTT MD

MEDICARE: JONATHAN M PHILPOTT MD
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician0110232654VA
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianMD-19958HI

General Provider Information

NPI Number : 1457353229
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN M PHILPOTT MD
Provider Business Mailing Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Provider Business Practice Location Address
First Line : 3288 MOANALUA RD
Second Line :
City : HONOLULU
State : HI
Zip : 96819-1469
Country : US
Telephone Number : 808-432-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 08/30/2022

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