Provider Demographics
NPI:1073583068
Name:SIMON, HOWARD JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JOHN
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 E CAMELBACK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2400
Mailing Address - Country:US
Mailing Address - Phone:480-478-6545
Mailing Address - Fax:602-688-6122
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD
Practice Address - Street 2:SUITE 137
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5199
Practice Address - Country:US
Practice Address - Phone:480-614-8555
Practice Address - Fax:480-614-8666
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1119292085R0202X
AZ206332085R0202X
CAG870802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ110586Medicaid
AZZ109425Medicare PIN
AZZ133457Medicare PIN
AZF22548Medicare UPIN