Individual
DR. MARK A SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1202 W MAPLE ST, WICHITA, KS 67213-3916
(316) 262-3716
(316) 262-0784
Mailing address
1202 W MAPLE ST, WICHITA, KS 67213-3916
(316) 262-3716
(316) 262-0784
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1386-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005347
BCBS
KS
Enumeration date
02/02/2006
Last updated
03/11/2011
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