1457453060 NPI number — DR. GAREY S SIMMONDS M.D.

Table of content: DR. GAREY S SIMMONDS M.D. (NPI 1457453060)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457453060 NPI number — DR. GAREY S SIMMONDS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMMONDS
Provider First Name:
GAREY
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457453060
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15721 N GREENWAY HAYDEN LOOP
Provider Second Line Business Mailing Address:
#201
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85260-1650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-905-9211
Provider Business Mailing Address Fax Number:
480-905-0504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15721 N GREENWAY HAYDEN LOOP
Provider Second Line Business Practice Location Address:
#201
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85260-1650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-905-9211
Provider Business Practice Location Address Fax Number:
480-905-0504
Provider Enumeration Date:
09/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  23958 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 370453-01 . This is a "AHCSS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com