Individual
LISA J SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4501 EMPIRE CT, FREDERICKSBURG, VA 22408-1949
(540) 371-0079
(540) 656-2769
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101251664
VA
207RH0003X
Hematology & Oncology Physician
33840
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790773737
—
IA
05
—
2226035
—
IA
01
—
36328
WELLMARK BCBS
—
01
—
P00687435
RR MEDICARE
IA
Enumeration date
10/13/2005
Last updated
02/20/2026
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