Healthcare Provider Details

I. General information

NPI: 1639459068
Provider Name (Legal Business Name): JASON K KANE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PONAHAWAI ST STE 206
HILO HI
96720-7830
US

IV. Provider business mailing address

15-3011A MAKO WAY
PAHOA HI
96778-9747
US

V. Phone/Fax

Practice location:
  • Phone: 808-735-5597
  • Fax: 808-735-7904
Mailing address:
  • Phone: 307-461-7097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number146
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO-263
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: