Individual
ERIC A SIMMONS
Active
Individual
ERIC A SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0-300
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010146503
BLUE SHIELD INDIVIDUAL
ID
05
—
806503100
—
ID
01
—
S4802
BLUE CROSS INDIVIDUAL
ID
Enumeration date
03/19/2007
Last updated
05/09/2008
Update your record
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