Individual
ANTHONY RUSSELL SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
193 MAIN ST, NORWAY, ME 04268-5645
(207) 743-5366
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA639
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740391317
—
ME
Enumeration date
08/31/2006
Last updated
09/15/2021
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