Provider Demographics
NPI:1508881632
Name:SMITH, ALICE BOYD (MD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:BOYD
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:BETH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2938 PACIFIC HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-1015
Mailing Address - Country:US
Mailing Address - Phone:808-927-2882
Mailing Address - Fax:
Practice Address - Street 1:2938 PACIFIC HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-1015
Practice Address - Country:US
Practice Address - Phone:808-927-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI169352085D0003X
CAG875212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging