Provider Demographics
NPI:1396777090
Name:SIMONE, CYNTHIA A (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:SIMONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:TONKOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8901 WEST 74 STREET
Mailing Address - Street 2:STE 285
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-362-3210
Mailing Address - Fax:913-362-0407
Practice Address - Street 1:8901 W 74TH ST
Practice Address - Street 2:SUITE 285
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2204
Practice Address - Country:US
Practice Address - Phone:913-362-3210
Practice Address - Fax:913-362-0407
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12493152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU46536Medicare UPIN