Provider Demographics
NPI:1366605412
Name:SIMPSON, KAREN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELIZABETH
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8415 GOODWOOD BLVD
Mailing Address - Street 2:PEDIATRIC ACADEMIC CLINIC
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7851
Mailing Address - Country:US
Mailing Address - Phone:225-765-8013
Mailing Address - Fax:225-765-2033
Practice Address - Street 1:8415 GOODWOOD BLVD
Practice Address - Street 2:PEDIATRIC ACADEMIC CLINIC
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7851
Practice Address - Country:US
Practice Address - Phone:225-765-8013
Practice Address - Fax:225-765-2033
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 037180174400000X
LAMD 204495174400000X
LA204495208000000X
IL036-110509208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No174400000XOther Service ProvidersSpecialist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1423556Medicaid
247932YJA2Medicare PIN