Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 3106175-1205 | UT |
N | 207RC0200X | Critical Care Medicine | 3106175-1205 | UT |
NPI | 1609973684 |
---|---|
Provider Name | Robert I Simpson |
First Address | Provo, UT 84601-1547 |
Second Address | Provo, UT 84601-1547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 03/10/2016 |