Provider Demographics
NPI:1710176896
Name:JOHN V. SIMONS
Entity Type:Organization
Organization Name:JOHN V. SIMONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:501-321-2444
Mailing Address - Street 1:1900 MALVERN AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901
Mailing Address - Country:US
Mailing Address - Phone:501-321-2444
Mailing Address - Fax:501-321-9521
Practice Address - Street 1:1900 MALVERN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901
Practice Address - Country:US
Practice Address - Phone:501-321-2444
Practice Address - Fax:501-321-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR82213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56428OtherMEDICARE PROVIDER NUMBER