Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 39334 | SC |
NPI | 1225355316 |
---|---|
Provider Name | Joshua Perkins Simpson |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29605-4281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2010 |
Last Update Date | 12/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APPROVED | (05) | SC |