Provider Demographics
NPI:1578761219
Name:THOMAS W. POLLARD DO LLC
Entity Type:Organization
Organization Name:THOMAS W. POLLARD DO LLC
Other - Org Name:THOMAS W. POLLARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WELDON
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-486-0600
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-486-0600
Mailing Address - Fax:808-486-0633
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 570
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-486-0600
Practice Address - Fax:808-486-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS0671207RP1001X
HI363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty