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General NPI Number Information
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NPI Number | 1497932248
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Entity Type | Organization
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Legal Business Name | DOCKTOUR4U LLC
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 89 HOOKELE ST STE 102
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City | KAHULUI
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State | HI
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Zip | 96732-3532
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Country | US
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Telephone | 716-299-8570
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Fax | 855-954-0016
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Provider Business Mailing Address
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Address Line | PO BOX 1366
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City | HONOKAA
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State | HI
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Zip | 96727-1366
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Country | US
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Telephone | 716-299-8570
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Fax | 855-954-0016
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Authorized Official
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Title or Position | MEMBER/ MANAGER
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Name | DR. IRVING WILLIAM HARPER III
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Credential | MD
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Telephone | 716-299-8570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 12617
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License Number State | HI
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