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NPI Code Detail

MEDICARE: DR. JONAS A NAVICKAS DO

MEDICARE: DR. JONAS A NAVICKAS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDOS-783HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20000208298OTHERHIHMSA

General Provider Information

NPI Number : 1053496455
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONAS A NAVICKAS DO
Provider Business Mailing Address
First Line : 56-119 PUALALEA ST
Second Line :
City : KAHUKU
State : HI
Zip : 96731-2052
Country : US
Telephone Number : 808-293-9231
Fax Number : 808-293-1151
Provider Business Practice Location Address
First Line : 2239 N SCHOOL ST
Second Line :
City : HONOLULU
State : HI
Zip : 96819-2539
Country : US
Telephone Number : 808-791-9400
Fax Number : 808-848-0979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/03/2016

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Directions to “ DR. JONAS A NAVICKAS DO” Practice Location

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