Provider Demographics
NPI:1730225400
Name:SIMMONS, GINA DENISE (OD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:DENISE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7970 E THOMPSON PEAK PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7407
Mailing Address - Country:US
Mailing Address - Phone:480-874-3937
Mailing Address - Fax:
Practice Address - Street 1:7970 E THOMPSON PEAK PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7407
Practice Address - Country:US
Practice Address - Phone:480-874-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist