Provider Demographics
NPI:1932334968
Name:SIMONDS, LORRAINE STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:STANLEY
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7698
Mailing Address - Country:US
Mailing Address - Phone:678-906-9010
Mailing Address - Fax:
Practice Address - Street 1:601 PROFESSIONAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7698
Practice Address - Country:US
Practice Address - Phone:678-906-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0035474207W00000X
GA069445207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology