Provider Demographics
NPI:1053425595
Name:JOHN F. SIMMONS M.D. P.C
Entity type:Organization
Organization Name:JOHN F. SIMMONS M.D. P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-684-3644
Mailing Address - Street 1:915 W HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:AL
Mailing Address - Zip Code:36340-1645
Mailing Address - Country:US
Mailing Address - Phone:334-684-3644
Mailing Address - Fax:334-684-6472
Practice Address - Street 1:915 W HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-1645
Practice Address - Country:US
Practice Address - Phone:334-684-3644
Practice Address - Fax:334-684-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000016076OtherBCBS
AL000016076Medicaid
FL0441944500Medicaid
AL0100304950OtherCLIA
AL0100304950OtherCLIA
ALC72799Medicare UPIN
AL000016076Medicaid