Provider Demographics
NPI:1144326497
Name:SAMPSELL, JB MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JB
Middle Name:MICHAEL
Last Name:SAMPSELL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:4370 KUKUI GROVE STREET
Mailing Address - Street 2:SUITE 3-211
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:808-274-3190
Mailing Address - Fax:808-274-3194
Practice Address - Street 1:4370 KUKUI GROVE STREET
Practice Address - Street 2:SUITE 3-211
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:808-274-3190
Practice Address - Fax:808-274-3194
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD104652084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51911814Medicaid
A 43920Medicare UPIN
HI52497Medicare ID - Type Unspecified