Provider Demographics
NPI:1215140850
Name:JEFFREY A SIMPSON, MD, LLC
Entity type:Organization
Organization Name:JEFFREY A SIMPSON, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-444-6868
Mailing Address - Street 1:345 MONTAUK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320
Mailing Address - Country:US
Mailing Address - Phone:860-444-6868
Mailing Address - Fax:860-437-0650
Practice Address - Street 1:345 MONTAUK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:860-444-6868
Practice Address - Fax:860-437-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010027396CT03OtherDR SIMPSON BC#
CT1447244504OtherAMY MARTIN APRN INDVL NPI
CT40000368CT05OtherEILEEN O'DONNELL APRN BC#
CT101886OtherAMY MARTIN APRN CTCRE#
CT400001886CT23OtherAMY MARTIN APRN BC#
CT764225OtherDR SIMPSON CTCRE GRP#
CT789897OtherDR SIMPSON CTCRE#
CT1063412542OtherEILEEN O'DONNELL APRN NPI
CT1275525156OtherDR SIMPSON INDVL NPI#
CT010027396CT03OtherDR SIMPSON BC#
CTR82744Medicare UPIN
CTS47007Medicare UPIN