Healthcare Provider Details

I. General information

NPI: 1649221946
Provider Name (Legal Business Name): HAWAII ISLAND RADIATION ONCOLOGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 WAIANUENUE AVE
HILO HI
96720-1227
US

IV. Provider business mailing address

PO BOX 1120
HONOLULU HI
96807-1120
US

V. Phone/Fax

Practice location:
  • Phone: 808-933-0625
  • Fax: 808-974-6864
Mailing address:
  • Phone: 808-933-0625
  • Fax: 808-974-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES T LAMBETH
Title or Position: OWNER
Credential: MD
Phone: 808-933-0625