Organization
SIMMONS MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R SIMMONS M.D. (MEDICAL DIRECTOR)
(620) 231-9669
Entity
Organization
Contact information
Practice address
1026 N HIGHWAY 69, FRONTENAC, KS 66763-8100
(620) 231-9669
(620) 231-4585
Mailing address
PO BOX 999, FRONTENAC, KS 66763-0999
(620) 231-9669
(620) 231-4585
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
04-24193
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058129
BCBS
KS
05
—
100151280B
—
KS
Enumeration date
09/20/2006
Last updated
12/28/2012
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