Provider Demographics
NPI:1720002199
Name:SIMONSON, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:SIMONSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13919B N MAY AVE # 212
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-5035
Mailing Address - Country:US
Mailing Address - Phone:888-991-1101
Mailing Address - Fax:903-787-5854
Practice Address - Street 1:3705 NW 63RD ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1937
Practice Address - Country:US
Practice Address - Phone:405-608-4290
Practice Address - Fax:903-787-5854
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK24589207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200073400AMedicaid