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General NPI Number Information
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NPI Number | 1346233640
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Entity Type | Organization
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Legal Business Name | BERNARD WILLIAM SIMIERITSCH
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15341 HIGHWAY 278
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City | DOUBLE SPRINGS
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State | AL
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Zip | 35553-2407
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Country | US
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Telephone | 205-489-3322
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Fax | 205-489-3325
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Provider Business Mailing Address
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Address Line | 15341 HIGHWAY 278
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City | DOUBLE SPRINGS
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State | AL
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Zip | 35553-2407
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Country | US
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Telephone | 205-489-3322
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Fax | 205-489-3325
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Authorized Official
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Title or Position | OWNER
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Name | BERNARD WILLIAM SIMIERITSCH
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Credential | MD
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Telephone | 205-489-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | AL
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