Doctor Name: | J LARRY SIMPSON |
NPI Number: | 1053582718 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | TN186 |
Business Practice Address: | 460 Medical Park Dr Suite 102 Lenoir City, TN - 377725782 |
Business Phone Number: | 8659881883 |
Business Fax Number: | |
Mailing Address: | 130 Mabry Hood Rd, Suite 103 KNOXVILLE |
State: | TN |
Postal Code: | 379222221 |
Phone Number: | 8656906702 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2008 |
NPI Last Update Date: | 03/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | TN186 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |