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General NPI Number Information
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NPI Number | 1821490509
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Entity Type | Individual
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Provider Name | SAVANNAH WILLSON SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-433-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 171 EUCALYPTUS PL
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City | HONOLULU
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State | HI
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Zip | 96818-1269
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Country | US
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Telephone | 405-248-3114
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 31782
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License Number State | OK
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