Provider Demographics
NPI:1043312887
Name:FAULKNER, ALAN R (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:FAULKNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WARD AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1600
Mailing Address - Country:US
Mailing Address - Phone:808-792-3937
Mailing Address - Fax:808-599-4818
Practice Address - Street 1:1100 WARD AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1600
Practice Address - Country:US
Practice Address - Phone:808-792-3937
Practice Address - Fax:808-599-4818
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD10871207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA219772OtherHMSA
HIMD10871OtherMDX
HI49312201Medicaid
HIB63293Medicare UPIN
HIA219772OtherHMSA