Healthcare Provider Details

I. General information

NPI: 1699803460
Provider Name (Legal Business Name): TIMOTHY J MCLAUGHLIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 06/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N KUAKINI ST STE 1101
HONOLULU HI
96817-6301
US

IV. Provider business mailing address

405 N KUAKINI ST STE 1101
HONOLULU HI
96817-6301
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-0400
  • Fax: 808-533-0401
Mailing address:
  • Phone: 808-533-0400
  • Fax: 808-533-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberDOS912
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: