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General NPI Number Information
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NPI Number | 1811144181
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Entity Type | Individual
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Provider Name | TODD E SIMON D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 3262 N WINDSONG DR BLDG 2
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2255
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Country | US
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Telephone | 928-759-5890
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Fax | 928-458-2091
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Provider Business Mailing Address
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Address Line | PO BOX 10880
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City | PRESCOTT
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State | AZ
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Zip | 86304-0880
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Country | US
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Telephone | 602-406-4786
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Fax | 916-636-4358
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 061656
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 061656
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 011868
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License Number State | AZ
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