Provider Demographics
NPI:1568415636
Name:SIMONS, GERALD B (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:B
Last Name:SIMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2727 S 144TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5225
Mailing Address - Country:US
Mailing Address - Phone:402-778-5250
Mailing Address - Fax:402-778-5216
Practice Address - Street 1:2727 S 144TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5225
Practice Address - Country:US
Practice Address - Phone:402-778-5250
Practice Address - Fax:402-778-5216
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE12886207Y00000X
IA23936207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE040006234OtherRAILROAD MEDICARE
NE1000007OtherUHCM
NE10026440200Medicaid
IA51601OtherBCBS OF IA
IA0983197Medicaid
NE2735OtherBCBSN
NE47061028913Medicaid
NE4731OtherMIDLANDS CHOICE
IA51601OtherBCBS OF IA
NE4731OtherMIDLANDS CHOICE