Provider Demographics
NPI:1316927692
Name:HEALY, JEFF T (MD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:T
Last Name:HEALY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:98-1079 MOANALUA ROAD
Mailing Address - Street 2:SUITE 590
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4716
Mailing Address - Country:US
Mailing Address - Phone:808-487-0076
Mailing Address - Fax:808-485-4593
Practice Address - Street 1:98-1079 MOANALUA ROAD
Practice Address - Street 2:SUITE 590
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4716
Practice Address - Country:US
Practice Address - Phone:808-487-0076
Practice Address - Fax:808-485-4593
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HI12346208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H15477Medicare UPIN