Provider Demographics
NPI:1881759314
Name:SIMPSON, KIRK W (MD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:W
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3017 BLOOMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1715
Mailing Address - Country:US
Mailing Address - Phone:612-721-6511
Mailing Address - Fax:612-721-0239
Practice Address - Street 1:1150 CENTRE POINTE CURV
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1280
Practice Address - Country:US
Practice Address - Phone:651-454-4939
Practice Address - Fax:651-454-1757
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN20906-3207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA96426Medicare UPIN