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NPI Code Detail

MEDICARE: DR. JOHN C SIMONS PH.D.

MEDICARE:  DR. JOHN C SIMONS  PH.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
1103TC2200XClinical Child & Adolescent Psychologist4298MA

General Provider Information

NPI Number : 1497979553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C SIMONS PH.D.
Provider Business Mailing Address
First Line : 160 LOCUST ST
Second Line :
City : DANVERS
State : MA
Zip : 01923-1644
Country : US
Telephone Number : 978-774-8980
Fax Number :
Provider Business Practice Location Address
First Line : 112 BOSTON ST
Second Line :
City : SALEM
State : MA
Zip : 01970-1402
Country : US
Telephone Number : 508-932-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN C SIMONS PH.D.” Practice Location

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