Provider Demographics
NPI:1801906573
Name:SIMMERS, CARL GREER (DO)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:GREER
Last Name:SIMMERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 23RD ST
Mailing Address - Street 2:PROFESSIONAL BUILDING
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223
Mailing Address - Country:US
Mailing Address - Phone:330-929-7331
Mailing Address - Fax:330-929-7331
Practice Address - Street 1:1900 23RD ST
Practice Address - Street 2:PROFESSIONAL BUILDING
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223
Practice Address - Country:US
Practice Address - Phone:330-929-7331
Practice Address - Fax:330-929-7331
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-002295207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A75053Medicare UPIN
0405871Medicare ID - Type Unspecified