Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 15916 | AZ |
NPI | 1235108002 |
---|---|
Provider Name | Gary F Simpson |
First Address | Tempe, AZ 85283-3392 |
Second Address | Tempe, AZ 85283-3392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50662 | (02) | AZ |