Healthcare Provider Details

I. General information

NPI: 1831546118
Provider Name (Legal Business Name): JEFFREY LYNN SIMMONS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5474 W DAYBREAK PKWY STE G3
SOUTH JORDAN UT
84009-5909
US

IV. Provider business mailing address

5474 W DAYBREAK PKWY STE G3
SOUTH JORDAN UT
84009-5909
US

V. Phone/Fax

Practice location:
  • Phone: 801-923-3935
  • Fax: 801-797-1258
Mailing address:
  • Phone: 801-923-3935
  • Fax: 801-797-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9799948-9934
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: