Healthcare Provider Details

I. General information

NPI: 1508881632
Provider Name (Legal Business Name): ALICE BOYD SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE BETH SMITH MD

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2938 PACIFIC HEIGHTS RD
HONOLULU HI
96813-1015
US

IV. Provider business mailing address

2938 PACIFIC HEIGHTS RD
HONOLULU HI
96813-1015
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-2882
  • Fax:
Mailing address:
  • Phone: 808-927-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number16935
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: