Individual
KATHARINE REGINA SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1349 MILSTEAD RD NE, CONYERS, GA 30012-3871
(770) 785-7546
(770) 761-8521
Mailing address
2400 BELLEVUE RD STE 21A, DUBLIN, GA 31021-2890
(478) 328-0281
(478) 328-0438
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4266
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003171361A
—
GA
Enumeration date
09/14/2011
Last updated
01/04/2021
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