Organization
ALAN D TICE MD LCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN D TICE MD (OWNER)
(808) 341-2020
Entity
Organization
Contact information
Practice address
1286 QUEEN EMMA ST, HONOLULU, HI 96813-2303
(808) 538-2882
(808) 537-4272
Mailing address
PO BOX 700309, KAPOLEI, HI 96709-0309
(808) 203-7943
(808) 693-8060
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
11162
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50586006
—
HI
Enumeration date
06/14/2007
Last updated
02/04/2010
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