Provider Demographics
NPI:1588667828
Name:SCOTTSBLUFF ORTHOPAEDIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:SCOTTSBLUFF ORTHOPAEDIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-635-1414
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:STE 120
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-0615
Mailing Address - Country:US
Mailing Address - Phone:308-635-1414
Mailing Address - Fax:308-635-1913
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:STE 120
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-0615
Practice Address - Country:US
Practice Address - Phone:308-635-1414
Practice Address - Fax:308-635-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE096495Medicare ID - Type UnspecifiedGROUP NUMBER