MEDICARE: JOSH DAVID 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	207R00000X	Internal Medicine Physician	003052	GA
2	207RH0003X	Hematology & Oncology Physician	064969	GA

General Provider Information

NPI Number	:	1942461132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSH DAVID SIMMONS MD

Provider Business Mailing Address
First Line	:	900 CAIRO RD
Second Line	:
City	:	THOMASVILLE
State	:	GA
Zip	:	31792-4255
Country	:	US
Telephone Number	:	229-227-5102
Fax Number	:	229-227-5193

Provider Business Practice Location Address
First Line	:	919 S BROAD ST
Second Line	:
City	:	THOMASVILLE
State	:	GA
Zip	:	31792-6114
Country	:	US
Telephone Number	:	229-584-5400
Fax Number	:	229-551-8643

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

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	09/17/2020

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