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General NPI Number Information
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NPI Number | 1053559781
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Entity Type | Organization
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Legal Business Name | JAMES E. SIMPSON D.M.D.
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 301 N DIVISION ST
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City | CARTERVILLE
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State | IL
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Zip | 62918-1205
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Country | US
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Telephone | 618-985-3515
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Fax | 618-985-3986
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Provider Business Mailing Address
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Address Line | PO BOX 433
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City | CARTERVILLE
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State | IL
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Zip | 62918-0433
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Country | US
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Telephone | 618-985-3515
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Fax | 618-985-3986
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Authorized Official
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Title or Position | OWNER
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Name | JAMES E SIMPSON
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Credential | DMD
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Telephone | 618-985-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019018834
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License Number State | IL
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