Healthcare Provider Details

I. General information

NPI: 1871827063
Provider Name (Legal Business Name): GEORGE ROBERT SIMMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MASONIC DR
ELIZABETHTOWN PA
17022-2199
US

IV. Provider business mailing address

1 MASONIC DR
ELIZABETHTOWN PA
17022-2199
US

V. Phone/Fax

Practice location:
  • Phone: 717-367-1121
  • Fax: 717-361-5390
Mailing address:
  • Phone: 717-367-1121
  • Fax: 717-361-5390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD034191E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: