Provider Demographics
NPI:1235137324
Name:SIMONS, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:SIMONS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE B 420
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:404-252-9751
Mailing Address - Fax:678-990-5763
Practice Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE B 420
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5382
Practice Address - Country:US
Practice Address - Phone:404-252-9751
Practice Address - Fax:678-990-5763
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2011-04-13
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Provider Licenses
StateLicense IDTaxonomies
GA042434208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000712973FMedicaid
GA000712973DMedicaid