Provider Demographics
NPI:1003926312
Name:SIMMONS, ROBERT E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:STE 300
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3444
Mailing Address - Country:US
Mailing Address - Phone:316-282-9614
Mailing Address - Fax:316-284-9602
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3444
Practice Address - Country:US
Practice Address - Phone:316-282-9614
Practice Address - Fax:316-284-9602
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-16867207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100137810BMedicaid
KS052781Medicare ID - Type Unspecified
B68615Medicare UPIN