Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2014-01238 | NC |
N | 207P00000X | Emergency Physician | D0066108 | MD |
N | 207P00000X | Emergency Physician | MD449522 | PA |
Y | 207RC0200X | Critical Care Medicine | MD449522 | PA |
N | 2086S0102X | Surgical Critical Care | D0066108 | MD |
N | 2086S0127X | Trauma Surgeon | D66108 | MD |
NPI | 1124241542 |
---|---|
Provider Name | Dell E Simmons JR. |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-3676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 01/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002998792 | HIGHMARK BLUE SHIELD (01) | PA |
102848449 | (05) | PA |
1124241542 | (05) | NC |
1623104 | GATEWAY (01) | PA |
187MX | BCBS NC (01) | NC |
415167400 | (05) | MD |
420288 | UPMC (01) | PA |
P00784514 | RAILROAD MEDICARE (01) | MD |