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General NPI Number Information
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NPI Number | 1134106503
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Entity Type | Individual
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Provider Name | LIJO SIMPSON MBBS
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 1050 EAGLES LANDING PKWY STE 302
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-9250
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Country | US
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Telephone | 770-507-0700
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Fax | 770-507-7463
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Provider Business Mailing Address
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Address Line | 1100 JOHNSON FERRY RD NE SUITE 510
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City | SANDY SPRINGS
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State | GA
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Zip | 30342-1709
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Country | US
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Telephone | 404-419-1165
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Fax | 404-419-1164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 61344
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License Number State | GA
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