Provider Demographics
NPI:1821130766
Name:HARRISON, ROBERT CAMPBELL III (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAMPBELL
Last Name:HARRISON
Suffix:III
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 1:6700 KALANIANAOLE HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1277
Mailing Address - Country:US
Mailing Address - Phone:808-395-4454
Mailing Address - Fax:808-396-4425
Practice Address - Street 1:6700 KALANIANAOLE HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1277
Practice Address - Country:US
Practice Address - Phone:808-395-4454
Practice Address - Fax:808-396-4425
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI53189Medicare ID - Type Unspecified