Provider Demographics
NPI:1467547463
Name:HEWSON, JAMES KENNETH (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KENNETH
Last Name:HEWSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 LILIHA STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-526-0507
Mailing Address - Fax:808-523-3096
Practice Address - Street 1:2228 LILIHA STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-526-0507
Practice Address - Fax:808-523-3096
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 391174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHMSA65C PLUSOther0000049130
HI0000049130OtherHMSA
HIHMAOther192624
HIHMAAOther990256827
HITRICAREOther990256827
HIUHAOther990256827
HI52642801Medicaid
HI52642801Medicaid