Provider Demographics
NPI:1417258989
Name:J.V. SIMMERING M.D. INC.
Entity Type:Organization
Organization Name:J.V. SIMMERING M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:VIRGIL
Authorized Official - Last Name:SIMMERING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-329-4454
Mailing Address - Street 1:1300 MCGEE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5774
Mailing Address - Country:US
Mailing Address - Phone:405-329-4454
Mailing Address - Fax:405-329-6997
Practice Address - Street 1:1300 MCGEE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-5774
Practice Address - Country:US
Practice Address - Phone:405-329-4454
Practice Address - Fax:405-329-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6819208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1053309450OtherNPI -INDIVIDUAL