Provider Demographics
NPI:1538459391
Name:SIMMONS SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:SIMMONS SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEJA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:303-808-6282
Mailing Address - Street 1:8007 E LEHIGH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1534
Mailing Address - Country:US
Mailing Address - Phone:303-808-6282
Mailing Address - Fax:720-519-1471
Practice Address - Street 1:8007 E LEHIGH DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1534
Practice Address - Country:US
Practice Address - Phone:303-808-6282
Practice Address - Fax:720-519-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9104225363AS0400X
CO2076363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty