Provider Demographics
NPI:1609498906
Name:SIMMONS EYE ASSOCIATES
Entity Type:Organization
Organization Name:SIMMONS EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-559-2020
Mailing Address - Street 1:320 E FONTANERO ST STE 201
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7525
Mailing Address - Country:US
Mailing Address - Phone:719-599-2020
Mailing Address - Fax:719-632-6088
Practice Address - Street 1:5278 N NEVADA AVE STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8720
Practice Address - Country:US
Practice Address - Phone:719-559-2020
Practice Address - Fax:719-632-6088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMMONS EYE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty