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General NPI Number Information
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NPI Number | 1023315306
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Entity Type | Organization
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Legal Business Name | LAWRENCE A PEEBLES MD INC
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 81-6623 MAMALAHOA HWY
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City | KEALAKEKUA
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State | HI
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Zip | 96750-8130
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Country | US
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Telephone | 808-323-3855
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Fax | 808-323-2994
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Provider Business Mailing Address
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Address Line | 81-6623 MAMALAHOA HWY
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City | KEALAKEKUA
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State | HI
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Zip | 96750-8130
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Country | US
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Telephone | 808-323-3855
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Fax | 808-323-2994
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAWRENCE A PEEBLES
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Credential | MD
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Telephone | 808-323-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD3809
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License Number State | HI
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