Provider Demographics
NPI:1083656334
Name:SIMPSON, SCOTT C (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3715 E OVERLAND ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-855-5950
Mailing Address - Fax:208-855-5940
Practice Address - Street 1:3715 E OVERLAND ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-855-5950
Practice Address - Fax:208-855-5940
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2019-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM-8696207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty