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General NPI Number Information
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NPI Number | 1538149166
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Entity Type | Individual
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Provider Name | LEONARD WILLIAM SIMMONS P.A.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 765 6TH ST
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City | PENSACOLA
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State | FL
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Zip | 32511-5119
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Country | US
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Telephone | 850-452-6326
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Fax |
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Provider Business Mailing Address
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Address Line | 5551 NAVAHO DR
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City | PENSACOLA
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State | FL
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Zip | 32507-8759
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Country | US
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Telephone | 850-497-9931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9103209
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License Number State | FL
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