Basic Information
Provider Information
NPI: 1982041372
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMPSON
FirstName: RACHEL
MiddleName: GARTELL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 127 S 500 E STE 600
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841021971
CountryCode: US
TelephoneNumber: 8015876336
FaxNumber:  
Practice Location
Address1: 65 S MARIO CAPECCHI DR
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841320005
CountryCode: US
TelephoneNumber: 8015812352
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/27/2013
LastUpdateDate: 11/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XR74042AZN Allopathic & Osteopathic PhysiciansInternal Medicine 
207W00000XR74042AZY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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