Doctor Name: | DR. GLEN W. SIMONS |
NPI Number: | 1386641470 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 36709 |
Business Practice Address: | 3229 Summit Square Place Suite 150 Lexington, KY - 405092668 |
Business Phone Number: | 8594558346 |
Business Fax Number: | 8594558866 |
Mailing Address: | 3229 Summit Square Pl, Suite150 LEXINGTON |
State: | KY |
Postal Code: | 405092668 |
Phone Number: | 8594558346 |
Fax Number: | 8594558866 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 10/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 36709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |