Individual
DR. ROGER PANCOAST SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 JESSE HILL JR. DR., ATLANTA, GA 30303
(404) 616-4307
(404) 756-1402
Mailing address
720 WESTVIEW DR SW, HARRIS BUILDING STE. 100-A, ATLANTA, GA 30310-1458
(404) 756-1400
(404) 756-1402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
64970
GA
2084N0400X
Neurology Physician
Primary
64970
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100679B
—
GA
05
—
288365
—
OR
Enumeration date
07/12/2006
Last updated
12/22/2016
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