Healthcare Provider Details

I. General information

NPI: 1427283605
Provider Name (Legal Business Name): THOMAS RICHARDSON WILLIAMS III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE B7
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE B7
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-748-4700
  • Fax:
Mailing address:
  • Phone: 808-748-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-18096
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: