Provider Demographics
NPI:1437397387
Name:P. B. SIMPSON, JR., MD, LTD
Entity Type:Organization
Organization Name:P. B. SIMPSON, JR., MD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:P.
Authorized Official - Middle Name:B
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:870-536-8547
Mailing Address - Street 1:1220 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7109
Mailing Address - Country:US
Mailing Address - Phone:870-536-8547
Mailing Address - Fax:870-536-6452
Practice Address - Street 1:1220 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7109
Practice Address - Country:US
Practice Address - Phone:870-536-8547
Practice Address - Fax:870-536-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR2287207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102951001Medicaid
AR5DH13Medicare UPIN
AR102951001Medicaid