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General NPI Number Information
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NPI Number | 1356787857
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Entity Type | Organization
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Legal Business Name | GENEVA EMERGENCY ROOM DOCTORS LLC
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Dates
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Enumeration Date | 05/11/2013
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Last Update Date | 05/11/2013
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Provider Practice Location Address
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Address Line | 915 W HOSPITAL DR
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City | GENEVA
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State | AL
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Zip | 36340-1645
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Country | US
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Telephone | 334-684-3644
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Fax | 334-684-6472
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Provider Business Mailing Address
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Address Line | PO BOX 877
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City | GENEVA
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State | AL
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Zip | 36340-0877
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Country | US
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Telephone | 334-684-3644
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Fax | 334-684-6472
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Authorized Official
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Title or Position | OFFICER
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Name | DR. JOHN F SIMMONS
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Credential | MD
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Telephone | 334-684-3643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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