Basic Information
| Provider Information | |||||||||
| NPI: | 1912440090 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AARON J SMALL MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95-390 KUAHELANI AVE # 3AC-131 | ||||||||
| Address2: | |||||||||
| City: | MILILANI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967891192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084252376 | ||||||||
| FaxNumber: | 8888590148 | ||||||||
| Practice Location | |||||||||
| Address1: | 98-1079 MOANALUA RD | ||||||||
| Address2: | |||||||||
| City: | AIEA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967014713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084866000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2016 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | SMALL | ||||||||
| AuthorizedOfficialFirstName: | AARON | ||||||||
| AuthorizedOfficialMiddleName: | JUSTIN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8084252376 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD18102 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.