Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | DIO238 | HI |
Y | 156FX1800X | Optician | DIO238 | HI |
NPI | 1083868012 |
---|---|
Provider Name | Kevin P Mchugh |
First Address | Kailua Kona, HI 96740-2616 |
Second Address | Kailua Kona, HI 96740-2616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 04/11/2008 |