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NPI Code Detail

MEDICARE: DR. JONATHAN BROOKS SIMPSON DPM

MEDICARE: DR. JONATHAN BROOKS SIMPSON DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist638NC
2213EP1101XPrimary Podiatric Medicine Podiatrist638NC

General Provider Information

NPI Number : 1265833479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN BROOKS SIMPSON DPM
Provider Business Mailing Address
First Line : 355 W MARTIN LUTHER KING BLVD APT 2115
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-3081
Country : US
Telephone Number : 980-329-0006
Fax Number :
Provider Business Practice Location Address
First Line : 5960 FAIRVIEW RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-0202
Country : US
Telephone Number : 888-964-6681
Fax Number : 888-662-0859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2014
Last Update Date : 08/07/2023

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