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General NPI Number Information
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NPI Number | 1871687657
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Entity Type | Individual
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Provider Name | ISAAC WHITE JR. MSW
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 75-5995 KUAKINI HWY STE #413 DEPT OF VETERANS AFFAIRS
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City | KAILUA-KONA
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State | HI
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Zip | 96740
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Country | US
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Telephone | 808-329-0774
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Fax | 808-329-0776
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Provider Business Mailing Address
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Address Line | 73-1052 AHIKAWA STREET
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City | KAILUA-KONA
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State | HI
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Zip | 96740
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Country | US
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Telephone | 808-325-2095
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW1258
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License Number State | HI
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