Individual
TONY SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35753
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35753
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2174435B
MEDICARE
NC
01
—
3705
PARTNERS
—
01
—
4593492
AETNA
—
01
—
47267
MEDCOST
—
01
—
60067877
RR MEDICARE
—
05
—
6015867
—
VA
05
—
6020040000
—
WV
01
—
76311
BCBS
—
05
—
8976311
—
NC
05
—
Q35753
—
SC
Enumeration date
12/23/2005
Last updated
08/18/2017
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