MEDICARE: ALETA SIMMONS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	58342	TN

General Provider Information

NPI Number	:	1366708745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALETA SIMMONS M.D.

Provider Business Mailing Address
First Line	:	6339 CHARLOTTE PIKE # 712
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-2926
Country	:	US
Telephone Number	:	615-437-5001
Fax Number	:	615-919-9937

Provider Business Practice Location Address
First Line	:	6339 CHARLOTTE PIKE # 721
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-2926
Country	:	US
Telephone Number	:	615-437-5001
Fax Number	:	615-919-9937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	11/14/2022

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