Healthcare Provider Details

I. General information

NPI: 1962640979
Provider Name (Legal Business Name): ARTHUR J SIMON MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW STE 328
ATLANTA GA
30327-2119
US

IV. Provider business mailing address

3193 HOWELL MILL RD NW STE 328
ATLANTA GA
30327-2119
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-9355
  • Fax: 404-350-9069
Mailing address:
  • Phone: 404-350-9355
  • Fax: 404-350-9069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number031125
License Number StateGA

VIII. Authorized Official

Name: MR. ARTHUR J SIMON
Title or Position: PROVIDER OF SERVICE
Credential: MD
Phone: 404-350-9355