Provider Demographics
NPI:1881605129
Name:SIMPSON CHIROPRACTIC & PHYSICAL THERAPY CENTER
Entity type:Organization
Organization Name:SIMPSON CHIROPRACTIC & PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PT
Authorized Official - Phone:918-225-2225
Mailing Address - Street 1:1523 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-3039
Mailing Address - Country:US
Mailing Address - Phone:918-225-2225
Mailing Address - Fax:918-225-4915
Practice Address - Street 1:1523 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-3039
Practice Address - Country:US
Practice Address - Phone:918-225-2225
Practice Address - Fax:918-225-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1881605129OtherBLUE CROSS/BLUE SHIELD
OK700522197Medicare PIN