MEDICARE: BECKY SIMPSON, MD, PC

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	207V00000X	Obstetrics & Gynecology Physician	R1F29	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160026779	OTHER	MO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	100722	OTHER	MO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1902094238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BECKY SIMPSON, MD, PC

Provider Business Mailing Address
First Line	:	1029 NICHOLS RD STE A
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3008
Country	:	US
Telephone Number	:	573-302-1604
Fax Number	:	573-302-1610

Provider Business Practice Location Address
First Line	:	1029 NICHOLS RD STE A
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3008
Country	:	US
Telephone Number	:	573-302-1604
Fax Number	:	573-302-1610

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. BECKY A SIMPSON
Credential	:	MD
Telephone Number	:	573-302-1604

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	07/21/2010

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Directions to “BECKY SIMPSON, MD, PC ” Practice Location

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