Individual
DR. CAROLYN ELIZABETH SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
480 WARTAHOO LN, CANYONVILLE, OR 97417-9683
(541) 839-1345
(855) 670-1791
Mailing address
2371 NE STEPHENS ST STE 200, ROSEBURG, OR 97470-1399
(541) 672-8533
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9151
NV
207Q00000X
Family Medicine Physician
Primary
MD170122
OR
207Q00000X
Family Medicine Physician
MD60385919
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-16738
—
NV
01
—
9151
NEVADA STATE BOARD OF MED
NV
01
—
CS09655
NV BOARD OF PHARMACY
NV
01
—
MD170122
OREGON MEDICAL BOARD
OR
01
—
MD60385919
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
01/21/2006
Last updated
04/01/2019
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