Healthcare Provider Details

I. General information

NPI: 1649864471
Provider Name (Legal Business Name): OAHU EMERGENCY PHYSICIAN SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 N KUAKINI ST
HONOLULU HI
96817-2306
US

IV. Provider business mailing address

4932 SUNBEAM RD
JACKSONVILLE FL
32257-6128
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-2236
  • Fax:
Mailing address:
  • Phone: 904-346-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON FLEMING
Title or Position: PRESIDENT
Credential: MD
Phone: 808-384-2485