Healthcare Provider Details

I. General information

NPI: 1184499782
Provider Name (Legal Business Name): DOUGLAS L SMITH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 11/24/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP STREET SUITE 3007
HONOLULU HI
96813-3321
US

IV. Provider business mailing address

1188 BISHOP STREET SUITE 3007
HONOLULU HI
96813-3321
US

V. Phone/Fax

Practice location:
  • Phone: 808-599-3922
  • Fax: 808-599-8612
Mailing address:
  • Phone: 808-599-3922
  • Fax: 808-599-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS L SMITH
Title or Position: OWNER
Credential: MD
Phone: 808-599-3922