Provider Demographics
NPI:1902852833
Name:SIMPSON CARDIOVASCULAR, PC
Entity Type:Organization
Organization Name:SIMPSON CARDIOVASCULAR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FORD
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-759-5640
Mailing Address - Street 1:701 UNIVERSITY BLVD E
Mailing Address - Street 2:SUITE 808
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2086
Mailing Address - Country:US
Mailing Address - Phone:205-759-5640
Mailing Address - Fax:205-759-5639
Practice Address - Street 1:701 UNIVERSITY BLVD E
Practice Address - Street 2:SUITE 808
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-759-5640
Practice Address - Fax:205-759-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000145082086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529929130Medicaid
MS02873211OtherMEDICAID OF MS
358857200OtherACS PROVIDER #