Healthcare Provider Details

I. General information

NPI: 1902700453
Provider Name (Legal Business Name): MICHAEL TODD SIMPSON DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 CARSWELL AVE
NELLIS AFB NV
89191-7069
US

IV. Provider business mailing address

7073 ARCADIA GLEN CT
NORTH LAS VEGAS NV
89084-3161
US

V. Phone/Fax

Practice location:
  • Phone: 702-652-8835
  • Fax: 702-652-5536
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number1390
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: