Provider Demographics
NPI:1851340442
Name:MEARS, SIMON CAVENDISH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:CAVENDISH
Last Name:MEARS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112727
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-2727
Mailing Address - Country:US
Mailing Address - Phone:352-273-7002
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-7101
Practice Address - Country:US
Practice Address - Phone:352-273-7002
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9202207X00000X
MDD57491207X00000X
FLME164657207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR210757001Medicaid
MD401693900Medicaid
AR210757001Medicaid
AR423811YJJGMedicare PIN
TX318061YKTPMedicare PIN
MD401693900Medicaid