Healthcare Provider Details
I. General information
NPI: 1053381533
Provider Name (Legal Business Name): DAVID L SIMMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/25/2006
Last Update Date: 12/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5750 W. THUNDERBIRD RD SUITE A-100
GLENDALE AZ
85306-4660
US
IV. Provider business mailing address
2222 E HIGHLAND AVE STE 204
PHOENIX AZ
85016-4876
US
V. Phone/Fax
- Phone: 602-938-3205
- Fax: 602-938-5799
- Phone: 602-264-4834
- Fax: 602-257-8319
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 18526 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: