Provider Demographics
NPI:1568471928
Name:HUNGERFORD, GREGORY EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:EUGENE
Last Name:HUNGERFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66-560 KAMEHAMEHA HWY
Mailing Address - Street 2:STE. 5
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-1405
Mailing Address - Country:US
Mailing Address - Phone:808-780-2601
Mailing Address - Fax:808-637-2255
Practice Address - Street 1:66-560 KAMEHAMEHA HWY
Practice Address - Street 2:STE . 5
Practice Address - City:HALEIWA
Practice Address - State:HI
Practice Address - Zip Code:96712-1405
Practice Address - Country:US
Practice Address - Phone:808-780-2601
Practice Address - Fax:808-637-2255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1012111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDC1012OtherSTATE LICENSE
HIDC1012OtherSTATE LICENSE
HIU37109Medicare UPIN