Individual
CHARLES BLAKELY SIMPSON
Active
Individual
CHARLES BLAKELY SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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