Healthcare Provider Details

I. General information

NPI: 1588667828
Provider Name (Legal Business Name): SCOTTSBLUFF ORTHOPAEDIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W 42ND ST STE 120
SCOTTSBLUFF NE
69361-0615
US

IV. Provider business mailing address

2 W 42ND ST STE 120
SCOTTSBLUFF NE
69361-0615
US

V. Phone/Fax

Practice location:
  • Phone: 308-635-1414
  • Fax: 308-635-1913
Mailing address:
  • Phone: 308-635-1414
  • Fax: 308-635-1913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNE

VIII. Authorized Official

Name: DR. JAMES J SIMPSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 308-635-1414