Vivian Simmons Md Family Practice | |
169 N 2nd Ave Hartford AL 36344-1219 | |
(334) 588-0408 | |
(334) 588-0492 |
Full Name | Vivian Simmons Md Family Practice |
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Speciality | Family Medicine |
Location | 169 N 2nd Ave, Hartford, Alabama |
Authorized Official Name and Position | Vivian Simmons (OWNER) |
Authorized Official Contact | 3345880408 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vivian Simmons Md Family Practice 169 N 2nd Ave Hartford AL 36344-1219 Ph: (334) 588-0408 | Vivian Simmons Md Family Practice 169 N 2nd Ave Hartford AL 36344-1219 Ph: (334) 588-0408 |
NPI Number | 1366098972 |
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Provider Enumeration Date | 08/11/2019 |
Last Update Date | 08/11/2019 |
Medicare PECOS PAC ID | 9638501463 |
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Medicare Enrollment ID | O20191118001087 |
Identifier | Type | State | Issuer |
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1366098972 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Vivian Olsen Simmons |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093989519 PECOS PAC ID: 8022243609 Enrollment ID: I20170605000965 |
Provider Name | Allison Locke |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881140713 PECOS PAC ID: 1355611146 Enrollment ID: I20170727001453 |