Individual
MR. EVANS KENNARD SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
32 WISCASSETT AVE, HAMDEN, CT 06518-2531
(203) 407-0620
Mailing address
32 WISCASSETT AVE, HAMDEN, CT 06518-2531
(203) 407-0620
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001372
CT
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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