Provider Demographics
NPI:1508823170
Name:SIMPSON CHIROPRACTIC PA
Entity Type:Organization
Organization Name:SIMPSON CHIROPRACTIC PA
Other - Org Name:SIMPSON CHIROPRACTIC &SIMPSON LUKERT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-284-2205
Mailing Address - Street 1:914 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534
Mailing Address - Country:US
Mailing Address - Phone:785-284-2205
Mailing Address - Fax:785-284-2024
Practice Address - Street 1:914 MAIN ST
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534
Practice Address - Country:US
Practice Address - Phone:785-284-2205
Practice Address - Fax:785-284-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC3379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSC3379OtherLICENSE
KS060906OtherBCBS
KS060906OtherBCBS
KS060906Medicare ID - Type Unspecified