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General NPI Number Information
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NPI Number | 1750945697
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Entity Type | Individual
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Provider Name | THOMAS JAY KEOLA KANE IV MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 91 PARKER HILL AVE
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City | BOSTON
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State | MA
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Zip | 02120-3215
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Country | US
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Telephone | 508-308-6905
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 AALAPAPA DR
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City | KAILUA
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State | HI
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Zip | 96734-3269
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Country | US
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Telephone |
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MDR-7701
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 1022620
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License Number State | MA
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