Provider Demographics
NPI:1598785750
Name:SIMMONS, DEBRA BOOZER (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:BOOZER
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-5473
Mailing Address - Country:US
Mailing Address - Phone:337-531-3543
Mailing Address - Fax:
Practice Address - Street 1:1585 3RD ST
Practice Address - Street 2:BAYNE-JONES ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459
Practice Address - Country:US
Practice Address - Phone:337-531-3543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030570207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine