Healthcare Provider Details

I. General information

NPI: 1457181257
Provider Name (Legal Business Name): JW RS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/17/2024
Certification Date: 08/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 607
HONOLULU HI
96814-4403
US

IV. Provider business mailing address

3150 MONSARRAT AVE STE 200
HONOLULU HI
96815-4488
US

V. Phone/Fax

Practice location:
  • Phone: 808-947-2345
  • Fax:
Mailing address:
  • Phone: 808-722-2181
  • Fax: 808-734-5923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH WARD
Title or Position: MEMBER
Credential: MD
Phone: 808-349-5639