Provider Demographics
NPI:1386737070
Name:SIMMONS, LORENZA A (MD)
Entity type:Individual
Prefix:DR
First Name:LORENZA
Middle Name:A
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3886 PRINCETON LAKES WAY SW
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5511
Mailing Address - Country:US
Mailing Address - Phone:404-346-7100
Mailing Address - Fax:404-346-1122
Practice Address - Street 1:3886 PRINCETON LAKES WAY SW
Practice Address - Street 2:SUITE 280
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5511
Practice Address - Country:US
Practice Address - Phone:404-346-7100
Practice Address - Fax:404-346-1122
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057494207V00000X
GA57494207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA633294336BMedicaid
GA633294336BMedicaid