Healthcare Provider Details

I. General information

NPI: 1518951797
Provider Name (Legal Business Name): NANCY L SIMON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 MALSBARY RD
CINCINNATI OH
45242-5621
US

IV. Provider business mailing address

5053 WOOSTER RD
CINCINNATI OH
45226-2326
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-2273
  • Fax: 513-792-5844
Mailing address:
  • Phone: 513-751-2145
  • Fax: 513-751-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35059061
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number26929
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: