Provider Demographics
NPI:1902959166
Name:SIMONSON, JAMES ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:SIMONSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 PARK MEADOWS CENTER DR
Mailing Address - Street 2:SUITE1000
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5005
Mailing Address - Country:US
Mailing Address - Phone:303-649-9500
Mailing Address - Fax:303-706-9062
Practice Address - Street 1:8405 PARK MEADOWS CENTER DR
Practice Address - Street 2:SUITE1000
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5005
Practice Address - Country:US
Practice Address - Phone:303-649-9500
Practice Address - Fax:303-706-9062
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COY07415Medicare UPIN
COC532448Medicare ID - Type Unspecified