Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 15421 | WV |
NPI | 1336413335 |
---|---|
Provider Name | Dr. Rodney Michael Simpkins |
First Address | Scott Depot, WV 25560-9565 |
Second Address | Scott Depot, WV 25560-9565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2012 |
Last Update Date | 08/03/2012 |