Provider Demographics
NPI:1275922833
Name:DR. SIDNEY H. SIMPSON P. A.
Entity Type:Organization
Organization Name:DR. SIDNEY H. SIMPSON P. A.
Other - Org Name:SIMPSON CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:HOLLIS
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-394-3540
Mailing Address - Street 1:1142 HIGHWAY 71 S
Mailing Address - Street 2:SUITE D
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8078
Mailing Address - Country:US
Mailing Address - Phone:479-394-3540
Mailing Address - Fax:479-394-7531
Practice Address - Street 1:1142 HIGHWAY 71 S
Practice Address - Street 2:SUITE D
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8078
Practice Address - Country:US
Practice Address - Phone:479-394-3540
Practice Address - Fax:479-394-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR963305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59837Medicare PIN