| Vivian Simmons Md Family Practice | |
|
169 N 2nd Ave Hartford AL 36344-1219 | |
| (334) 588-0408 | |
| (334) 588-0492 |
| Full Name | Vivian Simmons Md Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 169 N 2nd Ave, Hartford, Alabama |
| Authorized Official Name and Position | Vivian Simmons (OWNER) |
| Authorized Official Contact | 3345880408 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivian Simmons Md Family Practice 169 N 2nd Ave Hartford AL 36344-1219 Ph: (334) 588-0408 | Vivian Simmons Md Family Practice 169 N 2nd Ave Hartford AL 36344-1219 Ph: (334) 588-0408 |
| NPI Number | 1366098972 |
|---|---|
| Provider Enumeration Date | 08/11/2019 |
| Last Update Date | 08/11/2019 |
| Medicare PECOS PAC ID | 9638501463 |
|---|---|
| Medicare Enrollment ID | O20191118001087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366098972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vivian Olsen Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093989519 PECOS PAC ID: 8022243609 Enrollment ID: I20170605000965 |
| Provider Name | Allison Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881140713 PECOS PAC ID: 1355611146 Enrollment ID: I20170727001453 |