Healthcare Provider Details
I. General information
NPI: 1598864571
Provider Name (Legal Business Name): FRANK PORTER HURST JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 05/19/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
76-6225 KUAKINI HWY STE A107
KAILUA KONA HI
96740-3212
US
IV. Provider business mailing address
76-6225 KUAKINI HWY STE A107
KAILUA KONA HI
96740-3212
US
V. Phone/Fax
- Phone: 808-326-1944
- Fax:
- Phone: 808-326-1944
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | MD12866 |
| License Number State | HI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD-12866 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: