Individual
JORDAN SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
1041 VILLA VISTA DR, AMMON, ID 83406-1268
(208) 757-1567
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
O-1399
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/10/2014
Last updated
12/04/2023
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