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NPI Code Detail

MEDICARE: DR. MARCUS L SIMMONS MD

MEDICARE:  DR. MARCUS L SIMMONS  MD
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
1207R00000XInternal Medicine Physician049946GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3202167625OTHERGAFEDERAL TAX ID

General Provider Information

NPI Number : 1770511180
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCUS L SIMMONS MD
Provider Business Mailing Address
First Line : 5569 HOUSTON RD
Second Line :
City : MACON
State : GA
Zip : 31216-5709
Country : US
Telephone Number : 478-781-5065
Fax Number : 478-781-0012
Provider Business Practice Location Address
First Line : 5569 HOUSTON RD
Second Line :
City : MACON
State : GA
Zip : 31216-5709
Country : US
Telephone Number : 478-781-5065
Fax Number : 478-781-0012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 12/13/2016

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Directions to “ DR. MARCUS L SIMMONS MD” Practice Location

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