Individual
TIMOTHY SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N DECATUR RD, SUITE 120, DECATUR, GA 30033-5949
(770) 277-4277
(404) 292-6305
Mailing address
2801 N DECATUR RD, SUITE 120, DECATUR, GA 30033-5949
(770) 277-4277
(404) 292-6305
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
040846
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00947086A
—
GA
01
—
10556
KAISER
—
01
—
1700465
UNITED HEALTHCARE
—
01
—
2969776
AETNA HMO
—
01
—
4608346001
CIGNA HMO
—
01
—
52439381
BCBS
—
01
—
7375431
AETNA NON HMO
—
Enumeration date
05/04/2006
Last updated
02/26/2021
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