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General NPI Number Information
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NPI Number | 1629183801
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Entity Type | Organization
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Legal Business Name | MID PACIFIC ENT INSTITUTE INC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 405 N KUAKINI ST #902
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City | HONOLULU
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State | HI
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Zip | 96817-6302
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Country | US
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Telephone | 808-533-0400
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Fax | 808-533-0401
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Provider Business Mailing Address
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Address Line | 405 N KUAKINI ST #902
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City | HONOLULU
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State | HI
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Zip | 96817-6302
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Country | US
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Telephone | 808-533-0400
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Fax | 808-533-0401
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | TIMOTHY J MCLAUGHLIN
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Credential | DO
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Telephone | 808-533-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | D05912
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License Number State | HI
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