Provider Demographics
NPI:1154312973
Name:LINDELL, KENNETH KOPF (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:KOPF
Last Name:LINDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:673 MOKAPU RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1628
Mailing Address - Country:US
Mailing Address - Phone:808-254-4544
Mailing Address - Fax:
Practice Address - Street 1:TRIPLER ARMY MEDICAL CENTER
Practice Address - Street 2:1 JARRETT WHITE ROAD
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859
Practice Address - Country:US
Practice Address - Phone:808-433-6669
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI99432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology