Individual
DR. MARCUS L SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5569 HOUSTON RD, MACON, GA 31216-5709
(478) 781-5065
(478) 781-0012
Mailing address
5569 HOUSTON RD, MACON, GA 31216-5709
(478) 781-5065
(478) 781-0012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
049946
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000863475C
—
GA
05
—
00863475B
—
GA
01
—
202167625
FEDERAL TAX ID
GA
Enumeration date
06/28/2006
Last updated
12/13/2016
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