MEDICARE: MICHAEL D SIMPSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	055647	GA
2	208000000X	Pediatrics Physician	055647	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205823184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D SIMPSON M.D.

Provider Business Mailing Address
First Line	:	4480 N COOPER LAKE RD SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-4622
Country	:	US
Telephone Number	:	770-333-1300
Fax Number	:	770-432-8312

Provider Business Practice Location Address
First Line	:	4480 N COOPER LAKE RD SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-4622
Country	:	US
Telephone Number	:	770-333-1300
Fax Number	:	770-432-8312

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	04/17/2014

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