Individual
DR. WILSON FARRIS SURRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
888 S KING ST, HONOLULU, HI 96813-3097
(808) 522-4000
Mailing address
888 S KING ST, HONOLULU, HI 96813-3097
(808) 522-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29664
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
29964
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0483397001
CIGNA
NC
01
—
050032554
RAILROAD MEDICARE
NC
01
—
4597856
AETNA
NC
01
—
81019
BCBSNC
NC
01
—
85330
MEDCOST
NC
05
—
8981019
—
NC
05
—
N29964
—
SC
Enumeration date
05/24/2006
Last updated
06/30/2014
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