Provider Demographics
NPI:1356320832
Name:SIMPSON, JOHN B (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:651 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-5000
Mailing Address - Country:US
Mailing Address - Phone:870-942-1301
Mailing Address - Fax:870-942-1305
Practice Address - Street 1:651 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150
Practice Address - Country:US
Practice Address - Phone:870-942-1301
Practice Address - Fax:870-942-1305
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR889909OtherMEDICARE
AR102382001Medicaid
AR548707252Medicare PIN
ARD17097Medicare UPIN
ARP02266OtherNOVASYS
AR0120034OtherUNITED HEALTH CARE
AR5207030OtherAETNA
AR080193800OtherTRAVELERS MEDICARE
AR485692OtherHEALTHLINK
AR102382001Medicaid