Provider Demographics
NPI:1659454270
Name:SIMPSON, ROBERT L (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 TYRE NECK RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-4527
Mailing Address - Country:US
Mailing Address - Phone:757-484-7000
Mailing Address - Fax:
Practice Address - Street 1:20525 MARKET STREET
Practice Address - Street 2:
Practice Address - City:ONLEY
Practice Address - State:VA
Practice Address - Zip Code:23416
Practice Address - Country:US
Practice Address - Phone:757-787-4500
Practice Address - Fax:757-787-4795
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001023Medicare PIN
VAU73481Medicare UPIN