| Debra Kettleson Inc | |
|
670 Ponahawai St Ste 221 Hilo HI 96720-7829 | |
| (808) 365-5988 | |
| (808) 365-5989 |
| Full Name | Debra Kettleson Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 670 Ponahawai St Ste 221, Hilo, Hawaii |
| Authorized Official Name and Position | Debra Lynn Kettleson (OWNER/PROVIDER) |
| Authorized Official Contact | 8083655988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra Kettleson Inc 670 Ponahawai St Ste 221 Hilo HI 96720-7829 Ph: (808) 365-5988 | Debra Kettleson Inc 670 Ponahawai St Ste 221 Hilo HI 96720-7829 Ph: (808) 365-5988 |
| NPI Number | 1134525546 |
|---|---|
| Provider Enumeration Date | 11/12/2014 |
| Last Update Date | 01/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134525546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0381075 (Hawaii) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | 2009004214 (Hawaii) | Secondary |
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Carlos R. Abeyta Md, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 82 Puuhonu Pl, Suite 206, Hilo, HI 96720 Phone: 808-969-9888 Fax: 808-969-9881 | |
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Administration Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 Kilauea Ave Ste 105, Hilo, HI 96720 Phone: 808-961-4071 Fax: 808-961-5678 | |
Craig Y. Shikuma, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 82 Puuhonu Pl, Suite 207, Hilo, HI 96720 Phone: 808-935-5522 Fax: 808-961-5058 | |
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