Provider Demographics
NPI:1497932248
Name:DOCKTOUR4U LLC
Entity Type:Organization
Organization Name:DOCKTOUR4U LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:716-299-8570
Mailing Address - Street 1:PO BOX 1366
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1366
Mailing Address - Country:US
Mailing Address - Phone:716-299-8570
Mailing Address - Fax:855-954-0016
Practice Address - Street 1:89 HOOKELE ST STE 102
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3532
Practice Address - Country:US
Practice Address - Phone:716-299-8570
Practice Address - Fax:855-954-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12617261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care