Basic Information
| Provider Information | |||||||||
| NPI: | 1588001523 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HECKERT | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086911000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086911000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2013 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 61459 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD455117 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD0000054556 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD60647491 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD-20778 | HI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.