Provider Demographics
NPI:1922143742
Name:SIMPSON, GARY C (OD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:C
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:6305 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-3502
Mailing Address - Country:US
Mailing Address - Phone:520-795-7840
Mailing Address - Fax:520-298-0847
Practice Address - Street 1:6121 N PASEO VALDEAR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-1071
Practice Address - Country:US
Practice Address - Phone:520-795-7840
Practice Address - Fax:520-298-0847
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ219152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist