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Individual

RICHARD J SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 630-1400
(308) 632-7830
Mailing address
PO BOX 1886, SCOTTSBLUFF, NE 69361-1886
(308) 630-1400
(308) 632-7830

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
18303
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
25521
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4983
SD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5935A
WY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
G54216
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10453118 00
WY
01
2714
BCBS (CLASSIC AND PREFERR
01
4983
DAKOTACARE
SD
05
7706270
SD
Enumeration date
08/11/2006
Last updated
11/16/2007
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