Provider Demographics
NPI:1336113133
Name:SIMON, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLIAM
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 634172
Mailing Address - Street 2:COLUMBUS UROLOGY INC
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4172
Mailing Address - Country:US
Mailing Address - Phone:614-818-3576
Mailing Address - Fax:614-818-0217
Practice Address - Street 1:500 THOMAS LANE
Practice Address - Street 2:SUITE 3C COLUMBUS UROLOGY INC
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1419
Practice Address - Country:US
Practice Address - Phone:614-538-2222
Practice Address - Fax:614-538-2233
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35 04 5354S208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1900179OtherUHC
000000116897OtherANTHEM
OH0449410Medicaid
1900179OtherUHC
OH0449410Medicaid
C01938Medicare UPIN