Provider Demographics
NPI:1114947215
Name:SIMPSON, KASEY PAUL (PT, DC)
Entity Type:Individual
Prefix:DR
First Name:KASEY
Middle Name:PAUL
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-3039
Mailing Address - Country:US
Mailing Address - Phone:918-225-2225
Mailing Address - Fax:918-225-4915
Practice Address - Street 1:1523 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-3039
Practice Address - Country:US
Practice Address - Phone:918-225-2225
Practice Address - Fax:918-225-4915
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3481111N00000X
OK2062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1114947215OtherBLUE CROSS/BLUE SHIELD
OK247632102Medicare PIN
OK1114947215OtherBLUE CROSS/BLUE SHIELD
OKU76327Medicare UPIN