Basic Information
| Provider Information | |||||||||
| NPI: | 1578593216 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMMS | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | LYNDEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982641283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603890009 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24 CREE DR | ||||||||
| Address2: | |||||||||
| City: | LOCK HAVEN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 177452639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708935040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 06/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | K4247 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD033949E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0012611550016 | 05 | PA | MEDICAID |