Provider Demographics
NPI:1134286164
Name:HAWAII ISLAND RADIATION ONCOLOGY, LTD
Entity Type:Organization
Organization Name:HAWAII ISLAND RADIATION ONCOLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LAMBETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-933-0625
Mailing Address - Street 1:1285 WAIANUENUE AVE
Mailing Address - Street 2:SUITE1
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1227
Mailing Address - Country:US
Mailing Address - Phone:808-933-0625
Mailing Address - Fax:808-974-6864
Practice Address - Street 1:1285 WAIANUENUE AVE
Practice Address - Street 2:SUITE1
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1227
Practice Address - Country:US
Practice Address - Phone:808-933-0625
Practice Address - Fax:808-974-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 2876174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI25607901Medicaid
HIA041929Medicaid
HIA08934Medicare UPIN
HIA041929Medicaid
HI51389Medicare ID - Type UnspecifiedJAMES T. LAMBETH, M.D.
HIH54805Medicare ID - Type UnspecifiedKEVIN WILCOX, M.D.
HI25607901Medicaid