Healthcare Provider Details

I. General information

NPI: 1588752943
Provider Name (Legal Business Name): DONALD WILLIAM SIMPSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E BLOUNT AVE STE 800
KNOXVILLE TN
37920-1669
US

IV. Provider business mailing address

101 E BLOUNT AVE STE 800
KNOXVILLE TN
37920-1669
US

V. Phone/Fax

Practice location:
  • Phone: 865-632-5900
  • Fax: 865-637-2114
Mailing address:
  • Phone: 865-632-5900
  • Fax: 865-637-2114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA857
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: