Individual
MELVIN W SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
27 MAIN ST, VERGENNES, VT 05491-1113
(802) 877-2422
(802) 877-1124
Mailing address
27 MAIN ST, VERGENNES, VT 05491-1113
(802) 877-2422
(802) 877-1124
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000146
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007946
—
VT
01
—
344472
COMBINED INSURANCE CO
—
01
—
59V003
MVP
—
01
—
7946
BLUE CROSS BLUE SHIELD
—
01
—
83870
DAVIS VISION/G.E.
—
Enumeration date
08/22/2006
Last updated
07/08/2007
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