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NPI 1194061671

NPI 1194061671 : SLOAN WARREN KELLY MPAS, PA-C : TRIPLER AMC, HI

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General NPI Number Information
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    NPI Number           |    1194061671
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    Entity Type          |    Individual 
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    Provider Name        |    SLOAN WARREN KELLY MPAS, PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/02/2013
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    Last Update Date     |    10/29/2025
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Provider Practice Location Address
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    Address Line         |    1 JARRETT WHITE RD 
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    City                 |    TRIPLER AMC
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    State                |    HI
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    Zip                  |    96859-5001
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    Country              |    US
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    Telephone            |    888-683-2778
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    Fax                  |    808-433-5460
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Provider Business Mailing Address
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    Address Line         |    1 JARRETT WHITE RD 
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    City                 |    TRIPLER AMC
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    State                |    HI
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    Zip                  |    96859-5001
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    Country              |    US
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    Telephone            |    888-683-2778
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    Fax                  |    808-433-5460
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA08040
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    License Number State |    TX
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