Individual
DR. CHARLES KELLEY SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 OLD LARAMIE TRL E, LAFAYETTE, CO 80026-7012
(303) 926-9800
(303) 926-9891
Mailing address
120 OLD LARAMIE TRL E, LAFAYETTE, CO 80026-7012
(303) 926-9800
(303) 926-9801
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
28468
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01284686
—
CO
01
—
021766
KAISER COMMERCIAL NUMBER
CO
05
—
05854776
—
CO
01
—
840900897
TAX ID
CO
01
—
841537239
TAX ID
CO
Enumeration date
07/10/2006
Last updated
12/06/2022
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