Doctor Name: | MR. HARRY DADY SIMMONS |
NPI Number: | 1083753388 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 64851 |
Business Practice Address: | 11002 Detroit Ave Cleveland, OH - 44102 |
Business Phone Number: | 2162278668 |
Business Fax Number: | 2162279821 |
Mailing Address: | 11829 Clifton Blvd, Apt 5 LAKEWOOD |
State: | OH |
Postal Code: | 441072021 |
Phone Number: | 2162288988 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2007 |
NPI Last Update Date: | 12/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 64851 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |