Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD1257 | HI |
NPI | 1346456522 |
---|---|
Provider Name | Dr. Jack Hall Scaff JR. |
First Address | Honolulu, HI 96817-6300 |
Second Address | Honolulu, HI 96817-6300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C98610 | (02) | HI |
Y32956 | HMSA (01) | HI |