Provider Demographics
NPI:1730180159
Name:SIMPSON, HARVEY L III (MD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:L
Last Name:SIMPSON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2864 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8345
Mailing Address - Country:US
Mailing Address - Phone:770-693-2622
Mailing Address - Fax:770-693-5821
Practice Address - Street 1:821 N COBB ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2343
Practice Address - Country:US
Practice Address - Phone:478-454-3805
Practice Address - Fax:478-454-3975
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2017-04-24
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Provider Licenses
StateLicense IDTaxonomies
GA0394702085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00721278AMedicaid
GA92BDBGLMedicare PIN
G34893Medicare UPIN