Individual
SAMUEL SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1280 E CALVADA BLVD, PAHRUMP, NV 89048-5693
(775) 751-3377
(775) 751-2323
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
200272
AK
363A00000X
Physician Assistant
PA-1085
ID
363AM0700X
Medical Physician Assistant
Primary
PA1690
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619305828
—
NV
05
—
1736158
—
AK
Enumeration date
10/25/2013
Last updated
10/30/2025
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