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General NPI Number Information
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NPI Number | 1124106273
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Entity Type | Organization
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Legal Business Name | DR ROBERT R SIMPSON INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 400 ALLEN DR STE 300
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City | CHARLESTON
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State | WV
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Zip | 25302-3947
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Country | US
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Telephone | 304-342-6162
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Fax | 304-342-8309
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Provider Business Mailing Address
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Address Line | 1212 KANAWHA AVE
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City | DUNBAR
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State | WV
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Zip | 25064-3008
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Country | US
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Telephone | 304-766-6363
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Fax | 304-342-8309
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK WILSON SIMPSON
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Credential | DDS
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Telephone | 304-342-6162
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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 | 001
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License Number State | WV
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