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NPI Code Detail

MEDICARE: SEAN AMMON SIMMONS PA-C

MEDICARE: SEAN AMMON SIMMONS PA-C
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1710597687
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN AMMON SIMMONS PA-C
Provider Business Mailing Address
First Line : 3400 LARAMIE DR
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-2005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3400 LARAMIE DR
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-2005
Country : US
Telephone Number : 406-587-0122
Fax Number : 844-656-2480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2020
Last Update Date : 12/09/2025

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Directions to “ SEAN AMMON SIMMONS PA-C” Practice Location

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