Provider Demographics
NPI:1841033487
Name:SIMONS, NATALIE VICTORIA FLIEGEL (OD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:VICTORIA FLIEGEL
Last Name:SIMONS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:VICTORIA
Other - Last Name:FLIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2017 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1108
Mailing Address - Country:US
Mailing Address - Phone:205-910-4862
Mailing Address - Fax:
Practice Address - Street 1:500 FOOTHILL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14028752-9934152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management