Provider Demographics
NPI:1386617405
Name:SIMPSON, JAMES SCOTT (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SCOTT
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:J. SCOTT
Other - Middle Name:
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:310 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4569
Practice Address - Country:US
Practice Address - Phone:870-862-4216
Practice Address - Fax:870-862-9011
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2178152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106105722Medicaid
AR17248000040OtherQUALCHOICE
410040978OtherRAILROAD MEDICARE
AR17248000040OtherQUALCHOICE
T20241Medicare UPIN
AR106105722Medicaid