Basic Information
| Provider Information | |||||||||
| NPI: | 1194903898 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOHN K. UOHARA, M.D., INC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 82 PUUHONU PL | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089616608 | ||||||||
| FaxNumber: | 8089347445 | ||||||||
| Practice Location | |||||||||
| Address1: | 82 PUUHONU PL | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089616608 | ||||||||
| FaxNumber: | 8089347445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2008 | ||||||||
| LastUpdateDate: | 02/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | UOHARA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8089616608 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MD2891 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 4088-1 | 01 | HI | HMSA | OTHER |