Provider Demographics
NPI:1174600951
Name:SIMPSON, ROBERT SIDNEY (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SIDNEY
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 N MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-5236
Mailing Address - Country:US
Mailing Address - Phone:580-332-2332
Mailing Address - Fax:580-332-5593
Practice Address - Street 1:217 N MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-5236
Practice Address - Country:US
Practice Address - Phone:580-332-2332
Practice Address - Fax:580-332-5593
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK242412201Medicare ID - Type Unspecified