Healthcare Provider Details

I. General information

NPI: 1730180159
Provider Name (Legal Business Name): HARVEY L SIMPSON III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N COBB ST SUITE 100
MILLEDGEVILLE GA
31061-2343
US

IV. Provider business mailing address

2864 JOHNSON FERRY RD SUITE 150
MARIETTA GA
30062-8345
US

V. Phone/Fax

Practice location:
  • Phone: 478-454-3805
  • Fax: 478-454-3975
Mailing address:
  • Phone: 770-693-2622
  • Fax: 770-693-5821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number039470
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: