Provider Demographics
NPI:1063635464
Name:SIMMONDS, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:SIMMONDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1810 OLD LANTERN TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1421
Mailing Address - Country:US
Mailing Address - Phone:260-637-9041
Mailing Address - Fax:260-426-1914
Practice Address - Street 1:302 E JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3114
Practice Address - Country:US
Practice Address - Phone:260-426-2644
Practice Address - Fax:260-426-1914
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01038691B2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine