Provider Demographics
NPI:1366525016
Name:PERRYMAN, WILLIAM T (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:PERRYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 KILANI AVE
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1904
Mailing Address - Country:US
Mailing Address - Phone:808-621-8448
Mailing Address - Fax:808-621-3177
Practice Address - Street 1:1178A KINOOLE ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4133
Practice Address - Country:US
Practice Address - Phone:808-969-1419
Practice Address - Fax:808-969-1297
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5307207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI010834Medicaid
HI0000251538OtherHMSA (BCBS, HI)
HIC98890Medicare UPIN
HI010834Medicaid