Individual
CHARLES BLAKELY SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 934-9999
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
J0265
TX
207Y00000X
Otolaryngology Physician
Primary
L.5076DP
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117589502
—
TX
01
—
117589503
CIDC
TX
Enumeration date
08/07/2006
Last updated
02/03/2020
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