Provider Demographics
NPI:1760484570
Name:SIMON, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2400 S MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1000 E 23RD ST
Practice Address - Street 2:STE 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2114
Practice Address - Country:US
Practice Address - Phone:605-322-1625
Practice Address - Fax:605-322-1626
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2013-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA295802085R0001X
SD82852085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA28249OtherBLUE CROSS
92000626XOtherRAILROAD MEDICARE
MN173492000Medicaid
IA0233106Medicaid
SD7203440Medicaid
SD7203440Medicaid
IA0233106Medicaid
SDS105984Medicare PIN