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General NPI Number Information
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NPI Number | 1841473063
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Entity Type | Individual
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Provider Name | ANGEL NOVEL SIMMONS OD
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Gender | Female
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 7840 NATURAL BRIDGE RD PATIENT CARE CENTER
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City | SAINT LOUIS
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State | MO
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Zip | 63121-4617
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Country | US
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Telephone | 314-516-5131
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Fax | 314-516-5507
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Provider Business Mailing Address
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Address Line | 1 UNIVERSITY BLVD PATIENT CARE CENTER
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City | SAINT LOUIS
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State | MO
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Zip | 63121-4400
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Country | US
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Telephone | 314-516-5131
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Fax | 314-516-5507
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010023
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2004035653
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License Number State | MO
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