MEDICARE: DR. LATANYA C SIMPSON D.C.

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	111N00000X	Chiropractor	3184	NC

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
2	A262	OTHER	NC	PTAN

General Provider Information

NPI Number	:	1538144605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATANYA C SIMPSON D.C.

Provider Business Mailing Address
First Line	:	1704 MEDICAL PARK DR W
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-2705
Country	:	US
Telephone Number	:	252-991-4290
Fax Number	:	252-991-4291

Provider Business Practice Location Address
First Line	:	1704 MEDICAL PARK DR W
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-2705
Country	:	US
Telephone Number	:	252-991-4290
Fax Number	:	252-991-4291

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	06/20/2023

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