Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN006804 | GA |
Y | 213EG0000X | General Practice | DN006804 | GA |
NPI | 1003020595 |
---|---|
Provider Name | Dr. Barron David Simmons |
First Address | Athens, GA 30605-1331 |
Second Address | Athens, GA 30605-1331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 04/03/2015 |