MEDICARE: DR. DEBRA LYNN SIMMONS MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	8247254-1205	UT
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	E-1324	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	460001570	OTHER	AR	RAILROAD MEDICARE

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

General Provider Information

NPI Number	:	1588754063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA LYNN SIMMONS MD

Provider Business Mailing Address
First Line	:	615 S ARAPEEN DR
Second Line	:	SUITE 100
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1267
Country	:	US
Telephone Number	:	801-587-3926
Fax Number	:	801-587-3920

Provider Business Practice Location Address
First Line	:	615 S ARAPEEN DR
Second Line	:	SUITE 100
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1267
Country	:	US
Telephone Number	:	801-587-3926
Fax Number	:	801-587-3920

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	12/20/2021

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