Provider Demographics
NPI:1023197027
Name:LIM, FRANCIS T (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:T
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1134
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1134
Mailing Address - Country:US
Mailing Address - Phone:808-735-9093
Mailing Address - Fax:
Practice Address - Street 1:1585 ULUPII ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4444
Practice Address - Country:US
Practice Address - Phone:808-735-9093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2559174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03832301Medicaid
HI03832301Medicaid
HIH0000BDGGJMedicare ID - Type Unspecified