Provider Demographics
NPI:1972676450
Name:JEFF T HEALY MD LLC
Entity Type:Organization
Organization Name:JEFF T HEALY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:T
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-487-0076
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 590
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-487-0076
Mailing Address - Fax:808-485-4593
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE 590
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-487-0076
Practice Address - Fax:808-485-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12346208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty