Provider Demographics
NPI:1104909670
Name:UOHARA, JOHN K (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:UOHARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:K
Other - Last Name:UOHARA, M.D., INC.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:82 PUUHONU PL
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2010
Mailing Address - Country:US
Mailing Address - Phone:808-961-6608
Mailing Address - Fax:808-934-7445
Practice Address - Street 1:82 PUUHONU PL
Practice Address - Street 2:SUITE 205
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2010
Practice Address - Country:US
Practice Address - Phone:808-961-6608
Practice Address - Fax:808-934-7445
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2891207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03712401Medicaid
HI40881OtherHMSA
HI03712401Medicaid
C98664Medicare UPIN