MEDICARE: DR. JEFFREY LYNN SIMMONS OD

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	152W00000X	Optometrist	9799948-9934	UT

General Provider Information

NPI Number	:	1831546118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY LYNN SIMMONS OD

Provider Business Mailing Address
First Line	:	5474 W DAYBREAK PKWY STE G3
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5909
Country	:	US
Telephone Number	:	801-923-3935
Fax Number	:	801-797-1258

Provider Business Practice Location Address
First Line	:	5474 W DAYBREAK PKWY STE G3
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-5909
Country	:	US
Telephone Number	:	801-923-3935
Fax Number	:	801-797-1258

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

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	02/26/2026

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