Provider Demographics
NPI:1316770258
Name:FOOT AND ANKLE SPECIALISTS OF HAWAII LLC
Entity type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MISAKO
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-961-6655
Mailing Address - Street 1:67-1249 KOALIULA PL
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8463
Mailing Address - Country:US
Mailing Address - Phone:415-302-0239
Mailing Address - Fax:
Practice Address - Street 1:276 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2446
Practice Address - Country:US
Practice Address - Phone:808-961-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty