Provider Demographics
NPI:1598097289
Name:PINEHURST WELLNESS ASSOCIATES PLLC
Entity Type:Organization
Organization Name:PINEHURST WELLNESS ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-858-2206
Mailing Address - Street 1:3004 SEVEN LAKES WEST
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376
Mailing Address - Country:US
Mailing Address - Phone:414-858-2206
Mailing Address - Fax:
Practice Address - Street 1:35 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8708
Practice Address - Country:US
Practice Address - Phone:919-891-5014
Practice Address - Fax:919-782-6753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty