Individual
WILLIAM FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 984-7442
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1666
(808) 242-6464
(808) 984-7442
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC163
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235226
HMSA - 65CP - HMSA QUEST
HI
05
—
54551901
—
HI
01
—
990176859
HMAA
HI
Enumeration date
07/19/2006
Last updated
09/09/2010
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