Provider Demographics
NPI:1851354781
Name:SIMMONS, JEFFREY LAW (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LAW
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16 OAK MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-2214
Mailing Address - Country:US
Mailing Address - Phone:781-259-1484
Mailing Address - Fax:
Practice Address - Street 1:1 ENTERPRISE DR
Practice Address - Street 2:BLUE CROSS BLUE SHIELD OF MASSACHU
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2126
Practice Address - Country:US
Practice Address - Phone:617-246-5439
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA395372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry