Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 00014508 | AL |
NPI | 1124074497 |
---|---|
Provider Name | William Ford Simpson JR. |
First Address | Tuscaloosa, AL 35401-2086 |
Second Address | Tuscaloosa, AL 35401-2086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 30/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051534928 | (05) | AL |
09623570 | MEDICAID OF MS (01) | MS |
515-34928 | BCBS OF AL (01) | AL |
D95899 | (02) | |
P00358786 | RAILROAD MEDICARE PIN (01) |