Provider Demographics
NPI:1134159809
Name:SIMPSON, MATTHEW L (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:L
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 1:1909 N GREEN VALLEY PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8353
Mailing Address - Country:US
Mailing Address - Phone:702-898-1400
Mailing Address - Fax:702-898-1485
Practice Address - Street 1:1909 N GREEN VALLEY PKWY STE B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8353
Practice Address - Country:US
Practice Address - Phone:702-898-1400
Practice Address - Fax:702-898-1485
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU76427Medicare UPIN
NVV32411Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER