Provider Demographics
NPI:1407568751
Name:DR. ROGER PALMER
Entity Type:Organization
Organization Name:DR. ROGER PALMER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A/R SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-762-5270
Mailing Address - Street 1:1010 S KING ST STE 205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1703
Mailing Address - Country:US
Mailing Address - Phone:808-762-5270
Mailing Address - Fax:808-593-2243
Practice Address - Street 1:640 ULUKAHIKI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4454
Practice Address - Country:US
Practice Address - Phone:808-263-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty