Provider Demographics
NPI:1730216201
Name:FRANK G SIMON, PSC
Entity type:Organization
Organization Name:FRANK G SIMON, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-895-5088
Mailing Address - Street 1:1404 BROWNS LN STE B
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4655
Mailing Address - Country:US
Mailing Address - Phone:502-895-5088
Mailing Address - Fax:502-897-2426
Practice Address - Street 1:1404 BROWNS LN STE B
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4655
Practice Address - Country:US
Practice Address - Phone:502-895-5088
Practice Address - Fax:502-897-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14589207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY032587001OtherRAILROAD MEDICARE
KY64145899Medicaid
KY5483Medicare PIN
KY032587001OtherRAILROAD MEDICARE