Provider Demographics
NPI:1588343271
Name:SIMMS-SMAIL, KEVIN (ABO)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:SIMMS-SMAIL
Suffix:
Gender:M
Credentials:ABO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2077 SPOOKY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-8708
Mailing Address - Country:US
Mailing Address - Phone:412-812-3506
Mailing Address - Fax:
Practice Address - Street 1:2077 SPOOKY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-8708
Practice Address - Country:US
Practice Address - Phone:412-812-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician