Provider Demographics
NPI:1699819920
Name:SIMMONS, EARL MALCOLM III (MD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:MALCOLM
Last Name:SIMMONS
Suffix:III
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1010 1ST ST N
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8608
Mailing Address - Country:US
Mailing Address - Phone:205-664-9995
Mailing Address - Fax:205-621-9327
Practice Address - Street 1:1010 1ST ST N
Practice Address - Street 2:SUITE 350
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8608
Practice Address - Country:US
Practice Address - Phone:205-664-9995
Practice Address - Fax:205-621-9327
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL17756207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009965705Medicaid
AL51523914OtherBC BS OF AL
AL009965705Medicaid
AL051523914SIMMedicare ID - Type Unspecified