Provider Demographics
NPI:1487636098
Name:SIMPSON, DALE M (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:M
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:PO BOX 1402
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388-1402
Mailing Address - Country:US
Mailing Address - Phone:919-776-0303
Mailing Address - Fax:
Practice Address - Street 1:138 S STEELE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4201
Practice Address - Country:US
Practice Address - Phone:919-776-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76371OtherBCBS
NC8976371Medicaid
NCC76648Medicare UPIN
NC8976371Medicaid