MEDICARE: MRS. TEMPLE WALKER SIMPSON PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	TL1247	SC
2	363AM0700X	Medical Physician Assistant	1247	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285822148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TEMPLE WALKER SIMPSON PA-C

Provider Business Mailing Address
First Line	:	204 PARSONS RD
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-3348
Country	:	US
Telephone Number	:	854-201-3636
Fax Number	:	854-220-0121

Provider Business Practice Location Address
First Line	:	204 PARSONS RD
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-3348
Country	:	US
Telephone Number	:	854-220-0120
Fax Number	:	854-220-0121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	06/05/2020

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