Healthcare Provider Details

I. General information

NPI: 1003219643
Provider Name (Legal Business Name): SIMONS ENT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2014
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 S 144TH ST STE 250
OMAHA NE
68144-5236
US

IV. Provider business mailing address

2727 S 144TH ST STE 250
OMAHA NE
68144-5236
US

V. Phone/Fax

Practice location:
  • Phone: 402-778-5250
  • Fax: 402-778-5216
Mailing address:
  • Phone: 402-778-5250
  • Fax: 402-778-5216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: GERALD B SIMONS
Title or Position: OWNER
Credential: MD
Phone: 402-778-5250