Provider Demographics
NPI:1730166554
Name:ALLPORT, SIMON JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:SIMON
Middle Name:JOHN
Last Name:ALLPORT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:415 NORTH CENTER STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5036
Mailing Address - Country:US
Mailing Address - Phone:828-328-3300
Mailing Address - Fax:828-328-9101
Practice Address - Street 1:415 N CENTER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5036
Practice Address - Country:US
Practice Address - Phone:828-328-3300
Practice Address - Fax:828-328-9101
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9900007207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891195RMedicaid
NCG88788Medicare UPIN
NC891195RMedicaid