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General NPI Number Information
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NPI Number | 1578566428
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Entity Type | Individual
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Provider Name | DOUGLAS M WHITE DPT
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 55-3435 AKONI PULE HWY #7
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City | HAWI
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State | HI
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Zip | 96719
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Country | US
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Telephone | 617-696-1974
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Fax |
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Provider Business Mailing Address
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Address Line | 54-396 UNION MILL RD UNIT 1179
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City | KAPAAU
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State | HI
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Zip | 96755-3050
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Country | US
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Telephone | 808-796-3221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5659
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-5025
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License Number State | HI
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