Healthcare Provider Details

I. General information

NPI: 1720003874
Provider Name (Legal Business Name): ARTHUR J SIMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 06/18/2008
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 Code208200000X
TaxonomyPlastic Surgery Physician
License Number031125
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: