Healthcare Provider Details

I. General information

NPI: 1609046747
Provider Name (Legal Business Name): DAVID NORMAN SIMMONS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7659
US

IV. Provider business mailing address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7659
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-1100
  • Fax: 276-258-1125
Mailing address:
  • Phone: 276-258-1100
  • Fax: 276-258-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101243331
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0060183
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: