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General NPI Number Information
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NPI Number | 1730459454
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Entity Type | Organization
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Legal Business Name | REBECCA LYNN SIMON, M.D., P.A.
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 3864 HIGHWAY 392 W
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City | HARRISON
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State | AR
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Zip | 72601-9683
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Country | US
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Telephone | 870-204-5645
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Fax | 855-701-1410
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Provider Business Mailing Address
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Address Line | 3864 HIGHWAY 392 W
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City | HARRISON
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State | AR
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Zip | 72601-9683
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Country | US
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Telephone | 870-204-5645
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Fax | 855-701-1410
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. NICHOLAS CONRAD SIMON
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Credential |
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Telephone | 870-204-5645
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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 | E-5961
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License Number State | AR
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