Individual
DR. ISAC PHIL SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3456 E 17TH ST STE 190, AMMON, ID 83406-6749
(208) 524-2222
(855) 999-9242
Mailing address
3456 E 17TH ST STE 190, AMMON, ID 83406-6749
(208) 524-2222
(855) 999-9242
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-0854
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473675862
—
ID
Enumeration date
06/14/2011
Last updated
08/23/2022
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