MEDICARE: AMY SIMONE PA

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
1	363A00000X	Physician Assistant	005427	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346258613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY SIMONE PA

Provider Business Mailing Address
First Line	:	95 COLLIER RD NW STE 5015
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1721
Country	:	US
Telephone Number	:	404-605-6517
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 COLLIER RD NW STE 5015
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1721
Country	:	US
Telephone Number	:	404-605-6517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/20/2017

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Directions to “ AMY SIMONE PA” Practice Location

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