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Individual

DR. RUSSELL THOMAS SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
113 W CARPENTER ST, BENTON, AR 72015-3317
(501) 778-2363
(501) 778-5329
Mailing address
113 W CARPENTER ST, BENTON, AR 72015-3317
(501) 778-2363
(501) 778-5329

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2329
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139616722
AR
01
410041726
RAILROAD MEDICARE
AR
Enumeration date
06/30/2006
Last updated
08/13/2024
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