Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT.5772-THER | OH |
NPI | 1003080920 |
---|---|
Provider Name | Dr. Matthew Christopher Simpson |
First Address | Lexington, KY 40502-9987 |
Second Address | Lexington, KY 40502-9987 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 22/04/2008 |