Provider Demographics
NPI:1801826656
Name:SIMON, RICHARD S (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:SIMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 L ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4909
Mailing Address - Country:US
Mailing Address - Phone:202-659-5575
Mailing Address - Fax:202-296-9678
Practice Address - Street 1:2021 L ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4909
Practice Address - Country:US
Practice Address - Phone:202-659-5575
Practice Address - Fax:202-296-9678
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOP569152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management