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General NPI Number Information
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NPI Number | 1336438803
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Entity Type | Organization
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Legal Business Name | EDWARD D. SIMMONS MD PC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 235 NORTH ST
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City | BUFFALO
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State | NY
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Zip | 14201-1435
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Country | US
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Telephone | 716-882-0035
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Fax | 716-882-3032
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Provider Business Mailing Address
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Address Line | 235 NORTH ST
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City | BUFFALO
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State | NY
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Zip | 14201-1435
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Country | US
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Telephone | 716-882-0035
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Fax | 716-882-3032
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD DONALD SIMMONS
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Credential | M.D.
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Telephone | 716-882-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 007834
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 007619
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 177174
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License Number State | NY
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