Provider Demographics
NPI:1821065491
Name:SIMMONS, ORMAN W (MD)
Entity Type:Individual
Prefix:
First Name:ORMAN
Middle Name:W
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L LILE COURT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4415
Mailing Address - Country:US
Mailing Address - Phone:501-224-5500
Mailing Address - Fax:501-224-1166
Practice Address - Street 1:L LILE COURT
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4415
Practice Address - Country:US
Practice Address - Phone:501-224-5500
Practice Address - Fax:501-224-1166
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC3211207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106010OtherHEALTHLINK
AR1031259OtherUNITED HEALTHCARE
AR13905000000OtherQUALCHOICE
AR164158001Medicaid
AR4204397OtherAETNA
AR1031259OtherUNITED HEALTHCARE
AR13905000000OtherQUALCHOICE
AR54853Medicare PIN
AR160022844Medicare PIN