Provider Demographics
NPI:1649221946
Name:HAWAII ISLAND RADIATION ONCOLOGY LTD
Entity Type:Organization
Organization Name:HAWAII ISLAND RADIATION ONCOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAMBETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-933-0625
Mailing Address - Street 1:PO BOX 1120
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96807-1120
Mailing Address - Country:US
Mailing Address - Phone:808-933-0625
Mailing Address - Fax:808-974-6864
Practice Address - Street 1:1285 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1227
Practice Address - Country:US
Practice Address - Phone:808-933-0625
Practice Address - Fax:808-974-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH53380Medicare PIN