Provider Demographics
NPI:1386743193
Name:SIMPSON, JON H (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:H
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 MONROE ST
Mailing Address - Street 2:SUITE #8
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2733
Mailing Address - Country:US
Mailing Address - Phone:419-474-0629
Mailing Address - Fax:419-517-2046
Practice Address - Street 1:5660 MONROE ST
Practice Address - Street 2:SUITE #8
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2733
Practice Address - Country:US
Practice Address - Phone:419-474-0629
Practice Address - Fax:419-517-2046
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1831111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0887607Medicaid
OH4035711Medicare PIN
OHU08309Medicare UPIN