Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 18465 | MS |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 18465 | MS |
NPI | 1548271448 |
---|---|
Provider Name | Ryan Curtis Simmons |
First Address | Tupelo, MS 38803-2180 |
Second Address | Tupelo, MS 38801-6322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 07/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I13790 | (02) | MS |