Individual
CLYDE G SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5488 N ALABAMA AVE, OMEGA, GA 31775-3054
(229) 528-4546
(229) 528-4841
Mailing address
PO BOX 7627, TIFTON, GA 31793-7627
(229) 396-5830
(229) 391-3686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17301
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000191155A
—
GA
05
—
000191155E
—
GA
05
—
000191155F
—
GA
Enumeration date
04/13/2006
Last updated
03/26/2013
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