Provider Demographics
NPI:1841613197
Name:PARSONS, PAUL (LMT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:PARSONS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1384
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-1384
Mailing Address - Country:US
Mailing Address - Phone:808-280-6898
Mailing Address - Fax:
Practice Address - Street 1:411 HUKU LII PL
Practice Address - Street 2:302
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7062
Practice Address - Country:US
Practice Address - Phone:808-280-6898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI42772081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine