Provider Demographics
NPI:1316071566
Name:HERBERT SIMONS MD PC
Entity type:Organization
Organization Name:HERBERT SIMONS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-770-7100
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:SUITE 314
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3545 S TAMARAC DR
Practice Address - Street 2:SUITE 170
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1418
Practice Address - Country:US
Practice Address - Phone:303-770-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0838050001Medicare NSC