Healthcare Provider Details

I. General information

NPI: 1669305629
Provider Name (Legal Business Name): NEIL CHARLES WILLIAMSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-8635 MAILE DR
CAPTAIN COOK HI
96704
US

IV. Provider business mailing address

PO BOX 7238
OCEAN VIEW HI
96737-7238
US

V. Phone/Fax

Practice location:
  • Phone: 808-430-9436
  • Fax:
Mailing address:
  • Phone: 808-943-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberR-3834
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: