Individual
MR. MARTIN BRUCE SIMMONS
Active
Individual
MR. MARTIN BRUCE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OEG000681
PA
152W00000X
Optometrist
Primary
OPT006726
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016403560001
—
PA
01
—
1315299
AETNA HMO
PA
01
—
180649
HIGHMARK BLUE SHIELD
PA
01
—
1863649
KEYSTONE SR BLUE
PA
01
—
27541
HLTH ASSURANCE
PA
01
—
5106063
AETNA PPO
PA
Enumeration date
07/06/2006
Last updated
11/25/2019
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