Basic Information
| Provider Information | |||||||||
| NPI: | 1518385236 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIECHLE | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 AOLOA PLACE APARTMENT 211B | ||||||||
| Address2: | |||||||||
| City: | KAILUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967345257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128004272 | ||||||||
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| Practice Location | |||||||||
| Address1: | 770 KAPIOLANI BLVD, SUITE 705 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085978778 | ||||||||
| FaxNumber: | 8085978781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2014 | ||||||||
| LastUpdateDate: | 01/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD045155 | DC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD-19910 | HI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.