Doctor Name: | MR. SIMON LOUIS EDWARDS |
NPI Number: | 1013966092 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 914 |
Business Practice Address: | 8300 W 38th Ave Wheat Ridge, CO - 800336005 |
Business Phone Number: | 3034252525 |
Business Fax Number: | |
Mailing Address: | 126 N Greeley Ave, JOHNSTOWN |
State: | CO |
Postal Code: | 805348516 |
Phone Number: | 9705878794 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2006 |
NPI Last Update Date: | 11/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 914 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |