Provider Demographics
NPI:1043201494
Name:HOWARD, TIMOTHY QUINN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:QUINN
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 KAPAHULU AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-218-7889
Mailing Address - Fax:808-218-7891
Practice Address - Street 1:1029 KAPAHULU AVE STE 503
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-218-7889
Practice Address - Fax:808-218-7891
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant