Provider Demographics
NPI:1881221075
Name:SIMMONS PEDIATRICS
Entity type:Organization
Organization Name:SIMMONS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ERRINGTON
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:904-766-1106
Mailing Address - Street 1:1771 EDGEWOOD AVE W STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-7208
Mailing Address - Country:US
Mailing Address - Phone:904-766-1106
Mailing Address - Fax:904-766-1751
Practice Address - Street 1:1771 EDGEWOOD AVE W STE 1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-7208
Practice Address - Country:US
Practice Address - Phone:904-766-1106
Practice Address - Fax:904-766-1751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty