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NPI Code Detail

MEDICARE: GARY L SIMMONS DO

MEDICARE: GARY L SIMMONS DO
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
1207RH0003XHematology & Oncology Physician0102203383VA

General Provider Information

NPI Number : 1770802373
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY L SIMMONS DO
Provider Business Mailing Address
First Line : 6350 CENTER DR STE 200
Second Line :
City : NORFOLK
State : VA
Zip : 23502-4107
Country : US
Telephone Number : 757-905-5558
Fax Number :
Provider Business Practice Location Address
First Line : 6251 E VIRGINIA BEACH BLVD STE 200
Second Line :
City : NORFOLK
State : VA
Zip : 23502-2800
Country : US
Telephone Number : 757-466-8683
Fax Number : 757-466-8892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2010
Last Update Date : 02/28/2023

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