Individual
DR. DAVID CHARLES SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3155 CHANNING WAY STE B, IDAHO FALLS, ID 83404-7875
(208) 535-4420
(208) 524-1045
Mailing address
3155 CHANNING WAY STE B, IDAHO FALLS, ID 83404-7875
(208) 535-4420
(208) 524-1045
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
55495
TN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M-6825
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003919400
—
ID
01
—
20504
BLUE SHIELD
ID
01
—
DI197
BLUE CROSS
ID
Enumeration date
06/09/2006
Last updated
05/07/2025
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