Healthcare Provider Details

I. General information

NPI: 1205869260
Provider Name (Legal Business Name): VIRGIN ISLANDS EAR NOSE AND THROAT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS STE 308
ST THOMAS VI
00802-2687
US

IV. Provider business mailing address

9149 ESTATE THOMAS STE 308
ST THOMAS VI
00802-3132
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-8881
  • Fax:
Mailing address:
  • Phone: 340-774-8881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1208
License Number StateVI

VIII. Authorized Official

Name: JOSEPH R SMOLARZ
Title or Position: PROPRIETOR
Credential: M.D.
Phone: 340-774-8881