Basic Information
| Provider Information | |||||||||
| NPI: | 1396952420 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAVID B SIMMONS MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | DAVID B SIMMONS MD PA | ||||||||
| Address2: | 320 1ST STREET, N | ||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632995300 | ||||||||
| FaxNumber: | 8632995322 | ||||||||
| Practice Location | |||||||||
| Address1: | DAVID B SIMMONS MD PA | ||||||||
| Address2: | 320 1ST STREET, N | ||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632995300 | ||||||||
| FaxNumber: | 8632995322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 04/28/2008 | ||||||||
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| AuthorizedOfficialLastName: | SIMMONS | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8632995300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME60962 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.