Healthcare Provider Details

I. General information

NPI: 1831566173
Provider Name (Legal Business Name): MR. MICHAEL SIMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2015
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S PETERS RD STE 102
KNOXVILLE TN
37923-5217
US

IV. Provider business mailing address

212 S PETERS RD STE 102
KNOXVILLE TN
37923-5217
US

V. Phone/Fax

Practice location:
  • Phone: 865-279-3781
  • Fax:
Mailing address:
  • Phone: 865-279-3781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number677
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: