Individual
JAY H. CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1292 WAIANUENUE AVE, HILO, HI 96720-1228
(808) 934-4000
Mailing address
1292 WAIANUENUE AVE, HILO, HI 96720-1228
(808) 934-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD-647
HI
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744005700
—
MN
Enumeration date
08/15/2005
Last updated
05/26/2021
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