Provider Demographics
NPI:1508332610
Name:JASDO, INC.
Entity Type:Organization
Organization Name:JASDO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-887-6668
Mailing Address - Street 1:75-5660 KOPIKO ST STE C7-350
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3611
Mailing Address - Country:US
Mailing Address - Phone:808-887-6668
Mailing Address - Fax:808-887-0169
Practice Address - Street 1:73-4330 KEO KEO STREET
Practice Address - Street 2:
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96745
Practice Address - Country:US
Practice Address - Phone:808-887-6668
Practice Address - Fax:808-887-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty