Provider Demographics
NPI:1518137660
Name:DR GERALD J FELCHER
Entity Type:Organization
Organization Name:DR GERALD J FELCHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-828-6844
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754
Mailing Address - Country:US
Mailing Address - Phone:808-828-6844
Mailing Address - Fax:
Practice Address - Street 1:4270 KILAUEA RD
Practice Address - Street 2:SUITE I
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754
Practice Address - Country:US
Practice Address - Phone:808-828-6844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2009-10-28
Deactivation Date:2008-06-16
Deactivation Code:
Reactivation Date:2009-10-15
Provider Licenses
StateLicense IDTaxonomies
HIDC568111NR0200X
HI111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000QCCLGMedicare PIN
HI000000957-1Medicare PIN