Individual
WINNIE SUE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
798 SECOND AVE, MABEN, MS 39750-8761
(662) 263-5900
(662) 263-4132
Mailing address
798 SECOND AVE, MABEN, MS 39750-8761
(662) 263-5900
(662) 263-4132
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
07362
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117044
—
MS
Enumeration date
04/26/2006
Last updated
11/03/2009
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