Provider Demographics
NPI:1295815850
Name:SIMPSON, JON ALAN (MD)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:ALAN
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BROWN AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-7739
Mailing Address - Country:US
Mailing Address - Phone:931-484-8861
Mailing Address - Fax:931-456-1319
Practice Address - Street 1:118 BROWN AVE
Practice Address - Street 2:STE 103
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-7739
Practice Address - Country:US
Practice Address - Phone:931-484-8861
Practice Address - Fax:931-456-1319
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN020258207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
3106523OtherBCBS
TN020258OtherSTATE LICENSE NUMBER
TN0552370001OtherDME
TN200006546OtherACS NUMBER
TN3051154Medicaid
TN621419737OtherTAX ID
TN4084528Medicaid
TN1295815850OtherDME
TNCL3039OtherRAILROAD MEDICARE
TNCL3039OtherRAILROAD MEDICARE
TN0552370001OtherDME
TND93534Medicare UPIN
TN4084528Medicaid
TN3729283Medicare PIN