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General NPI Number Information
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NPI Number | 1417987306
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Entity Type | Organization
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Legal Business Name | HILO ACADEMIC PHYSICIANS INC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 07/27/2024
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Provider Practice Location Address
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Address Line | 615 PONAHAWAI ST STE 101
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City | HILO
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State | HI
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Zip | 96720-7665
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Country | US
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Telephone | 808-933-9187
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Fax | 808-961-5905
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Provider Business Mailing Address
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Address Line | 615 PONAHAWAI ST STE 101
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City | HILO
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State | HI
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Zip | 96720-7665
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Country | US
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Telephone | 808-933-9187
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Fax | 808-961-5905
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Authorized Official
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Title or Position | PRESIDENT
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Name | LYNDA DOLAN
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Credential | MD
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Telephone | 808-933-9187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5902
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4898
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9958
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License Number State | HI
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