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NPI Code Detail

MEDICARE: MARK SIMMONS DPT

MEDICARE: MARK SIMMONS DPT
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
1225100000XPhysical TherapistPTH6577AL
22251E1300XClinical Electrophysiology Physical TherapistCPO15837TNC
3225100000XPhysical Therapist11407TN
4225100000XPhysical TherapistPT010834GA

General Provider Information

NPI Number : 1225411457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK SIMMONS DPT
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : FORTSON
State : GA
Zip : 31808-0370
Country : US
Telephone Number :
Fax Number : 706-494-3008
Provider Business Practice Location Address
First Line : 6262 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-3540
Country : US
Telephone Number : 706-324-6661
Fax Number : 706-494-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 03/10/2026

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