Provider Demographics
NPI:1952443079
Name:GARDNER C QUARTON JR. MD INC.
Entity Type:Organization
Organization Name:GARDNER C QUARTON JR. MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARDNER
Authorized Official - Middle Name:C
Authorized Official - Last Name:QUARTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:808-821-2707
Mailing Address - Street 1:4520 KUKUI ST STE 101
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1770
Mailing Address - Country:US
Mailing Address - Phone:808-821-2707
Mailing Address - Fax:808-821-2803
Practice Address - Street 1:4520 KUKUI ST STE 101
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1770
Practice Address - Country:US
Practice Address - Phone:808-821-2707
Practice Address - Fax:808-821-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD4940261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery