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NPI Code Detail

MEDICARE: DR. JASON LEVON SIMMONS M.D.

MEDICARE:  DR. JASON LEVON SIMMONS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianBP10027620TX
2207R00000XInternal Medicine Physician266851NY

General Provider Information

NPI Number : 1164621041
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON LEVON SIMMONS M.D.
Provider Business Mailing Address
First Line : 2174 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-4326
Country : US
Telephone Number : 718-942-4984
Fax Number : 718-942-4987
Provider Business Practice Location Address
First Line : 2174 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-4326
Country : US
Telephone Number : 718-942-4984
Fax Number : 718-942-4987
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2007
Last Update Date : 02/22/2013

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Directions to “ DR. JASON LEVON SIMMONS M.D.” Practice Location

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