Provider Demographics
NPI:1538259643
Name:OPIE, NICHOLAS G JR (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:G
Last Name:OPIE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:354 ULUNIU ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2528
Mailing Address - Country:US
Mailing Address - Phone:808-261-5100
Mailing Address - Fax:808-263-9720
Practice Address - Street 1:354 ULUNIU ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2528
Practice Address - Country:US
Practice Address - Phone:808-261-5100
Practice Address - Fax:808-263-9720
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIT41245Medicare UPIN
HI0000QCBVPMedicare ID - Type Unspecified