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NPI Code Detail

MEDICARE: DR. LOUIS JOSEPH SIMONETTI JR. D.O.

MEDICARE: DR. LOUIS JOSEPH SIMONETTI JR. D.O.
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
1207Q00000XFamily Medicine PhysicianOS006144LPA

General Provider Information

NPI Number : 1972593812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS JOSEPH SIMONETTI JR. D.O.
Provider Business Mailing Address
First Line : PO BOX 525
Second Line :
City : PHOENIXVILLE
State : PA
Zip : 19460-0525
Country : US
Telephone Number : 610-933-8000
Fax Number : 610-917-1382
Provider Business Practice Location Address
First Line : 78 SECOND AVE
Second Line :
City : COLLEGEVILLE
State : PA
Zip : 19426-3646
Country : US
Telephone Number : 610-409-9999
Fax Number : 610-409-8470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2005
Last Update Date : 03/14/2016

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