Provider Demographics
NPI:1821142779
Name:SIMPSON, JANA LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:LOUISE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 MURCHISON DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2931
Mailing Address - Country:US
Mailing Address - Phone:915-544-3254
Mailing Address - Fax:915-544-1203
Practice Address - Street 1:1700 MURCHISON DR
Practice Address - Street 2:SUITE 215
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2931
Practice Address - Country:US
Practice Address - Phone:915-544-3254
Practice Address - Fax:915-544-1203
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6728207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG41274Medicare UPIN
TX00T86CMedicare ID - Type Unspecified