Provider Demographics
NPI:1437135993
Name:DIEBOLD, CARROLL J (MD)
Entity Type:Individual
Prefix:DR
First Name:CARROLL
Middle Name:J
Last Name:DIEBOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:95-518 POIKI PL
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1882
Mailing Address - Country:US
Mailing Address - Phone:808-433-6406
Mailing Address - Fax:808-433-4591
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY (MCHK-PS)
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-6406
Practice Address - Fax:808-433-4591
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD045522E2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry