Provider Demographics
NPI:1215993316
Name:FRANCIS, MARY LOU (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY LOU
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 PATTERSON RD
Mailing Address - Street 2:E-WING, R&D, ROOM 4-A101, (151)
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1522
Mailing Address - Country:US
Mailing Address - Phone:808-433-7786
Mailing Address - Fax:808-433-0379
Practice Address - Street 1:1833 KALAKAUA AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1527
Practice Address - Country:US
Practice Address - Phone:808-640-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-764174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI023588-7OtherHMSA