Provider Demographics
NPI:1871512558
Name:SIMPSON, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2247
Mailing Address - Country:US
Mailing Address - Phone:205-978-3200
Mailing Address - Fax:205-978-5745
Practice Address - Street 1:1936 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-2247
Practice Address - Country:US
Practice Address - Phone:205-978-3200
Practice Address - Fax:205-978-5745
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14325208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529701610Medicaid
AL90705OtherCIGNA PROVIDER NUMBER
AL000030026Medicaid
ALF936OtherBLUE CROSS COMMON PAYER
AL51030026OtherBLUE CROSS PROVIDER NUMBE
AL630307306015OtherTRICARE PROVIDER
AL1210242OtherUNITED HEALTHCARE
AL630307306OtherEMPLOYER TAX ID
AL0004114074OtherAETNA PROVIDER NUMBER