Individual
PETER SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 S CREASY LN, SUITE 130, LAFAYETTE, IN 47905-7438
(765) 447-7447
(765) 447-1767
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01067700A
IN
2085R0202X
Diagnostic Radiology Physician
A99981
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A999810
—
CA
05
—
200973600
—
IN
Enumeration date
06/12/2007
Last updated
06/15/2020
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