MEDICARE: ROSEMARY ROBERTS SIMPSON AU.D.

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	231H00000X	Audiologist	50257	TX

General Provider Information

NPI Number	:	1659537678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY ROBERTS SIMPSON AU.D.

Provider Business Mailing Address
First Line	:	4740 NE STALLINGS DR
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1615
Country	:	US
Telephone Number	:	936-569-8246
Fax Number	:	936-564-3246

Provider Business Practice Location Address
First Line	:	4740 NE STALLINGS DR
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1615
Country	:	US
Telephone Number	:	936-569-8246
Fax Number	:	936-564-3246

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	07/29/2008

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