Individual
MRS. IDELLA N SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
950 N ALABAMA ST, INDIANAPOLIS, IN 46202-3350
(317) 916-9946
(317) 916-9979
Mailing address
950 N ALABAMA ST, INDIANAPOLIS, IN 46202-3350
(317) 916-9946
(317) 916-9979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050509A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912085879
NPI
IN
Enumeration date
11/01/2006
Last updated
04/17/2013
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