Provider Demographics
NPI:1811961709
Name:SIMONS, LAWRENCE M SR (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:SIMONS
Suffix:SR
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 1:7030 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:HAYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67060-1471
Mailing Address - Country:US
Mailing Address - Phone:316-469-1099
Mailing Address - Fax:316-469-1098
Practice Address - Street 1:7030 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HAYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:67060-1471
Practice Address - Country:US
Practice Address - Phone:316-469-1099
Practice Address - Fax:316-469-1098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430198207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E52026Medicare UPIN
105092Medicare ID - Type Unspecified