Healthcare Provider Details

I. General information

NPI: 1275916207
Provider Name (Legal Business Name): DONALD SIMPSON II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

IV. Provider business mailing address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

V. Phone/Fax

Practice location:
  • Phone: 808-697-3469
  • Fax: 808-697-3551
Mailing address:
  • Phone: 808-697-3469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number036.145755
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD21230
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number31377
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.145755
License Number StateIL
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-21230
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: