Individual
SHELDON SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1915 W PARRISH AVE, STE 300, OWENSBORO, KY 42301-3519
(270) 683-4844
(270) 926-8366
Mailing address
1915 W PARRISH AVE, STE 300, OWENSBORO, KY 42301-3519
(270) 683-4844
(270) 926-8366
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
07000335A
IN
213E00000X
Podiatrist
Primary
119
KY
213ES0000X
Sports Medicine Podiatrist
00119
KY
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045182
ANTHEM
KY
05
—
100027980A
—
IN
05
—
45803004
—
KY
05
—
80001191
—
KY
05
—
90270307
—
KY
Enumeration date
12/02/2005
Last updated
10/06/2015
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