Provider Demographics
NPI:1730284357
Name:SIMPSON, SIDNEY H (DC)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:H
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:PO BOX 1304
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-1304
Mailing Address - Country:US
Mailing Address - Phone:479-394-3540
Mailing Address - Fax:479-394-7531
Practice Address - Street 1:1402-B HWY 71 S
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953
Practice Address - Country:US
Practice Address - Phone:479-394-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59837Medicare ID - Type Unspecified