Provider Demographics
NPI:1770577918
Name:SIMPKINS, KENNY (MD)
Entity type:Individual
Prefix:DR
First Name:KENNY
Middle Name:
Last Name:SIMPKINS
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 1:472 RANKIN DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-6568
Mailing Address - Country:US
Mailing Address - Phone:828-659-5700
Mailing Address - Fax:828-659-5785
Practice Address - Street 1:472 RANKIN DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-6568
Practice Address - Country:US
Practice Address - Phone:828-659-5700
Practice Address - Fax:828-659-5785
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32432208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76358OtherBCBS OF NC
NC2646046002OtherCIGNA PROVIDER #
NC1970515OtherUNITED HEALTH CARE
NC8976358Medicaid
NC1970515OtherUNITED HEALTH CARE
NC2646046002OtherCIGNA PROVIDER #