Healthcare Provider Details

I. General information

NPI: 1528578069
Provider Name (Legal Business Name): AMS DISTRICT OF COLUMBIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 19TH ST NW STE 850
WASHINGTON DC
20036-3700
US

IV. Provider business mailing address

28 N PALAFOX ST
PENSACOLA FL
32502-5626
US

V. Phone/Fax

Practice location:
  • Phone: 941-360-1566
  • Fax: 941-358-9818
Mailing address:
  • Phone: 941-360-1566
  • Fax: 941-358-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID W SIMPSON
Title or Position: PRESIDENT
Credential: MD
Phone: 941-556-8416