Healthcare Provider Details

I. General information

NPI: 1922045905
Provider Name (Legal Business Name): JOHN FRANKLIN SIMMONS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 W HOSPITAL DR
GENEVA AL
36340
US

IV. Provider business mailing address

915 W HOSPITAL DR
GENEVA AL
36340-1645
US

V. Phone/Fax

Practice location:
  • Phone: 334-684-3644
  • Fax: 334-684-6472
Mailing address:
  • Phone: 334-684-3644
  • Fax: 334-684-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number10418
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: