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NPI Code Detail

MEDICARE: DR. CAROL LYNN SIMMONS MD

MEDICARE:  DR. CAROL 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
1207V00000XObstetrics & Gynecology Physician14103SC

General Provider Information

NPI Number : 1972228229
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL LYNN SIMMONS MD
Provider Business Mailing Address
First Line : 2748 RUSH HAVEN DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29466-8578
Country : US
Telephone Number : 843-475-5989
Fax Number :
Provider Business Practice Location Address
First Line : 2748 RUSH HAVEN DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29466-8578
Country : US
Telephone Number : 843-475-5989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 10/10/2022

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Directions to “ DR. CAROL LYNN SIMMONS MD” Practice Location

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