Individual
SAMUEL CHARLES SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 MEDICAL CENTER DR, NEWTON, KS 67114
(316) 283-2700
(316) 283-1604
Mailing address
PO BOX 441, NEWTON, KS 67114
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54099
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012043
BCBS
KS
05
—
100246480A
—
KS
Enumeration date
02/01/2006
Last updated
08/26/2008
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