Martin-Simmerman, Phyllis
Martin-Simmerman, Phyllis is an individual health care provider with primary practice located at 253 Sagamore Pkwy W , West Lafayette IN 47906-1501. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Martin-Simmerman, Phyllis can be contacted via phone (765) 448-8000.Contact Information
Primary practice address
253 Sagamore Pkwy W
West Lafayette IN 47906-1501
Phone: (765) 448-8000
Fax: (765) 448-8335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01029841A | Indiana |
Profile Details
| NPI number | 1053380774 |
|---|---|
| LBN Legal business name | Martin-Simmerman, Phyllis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Jan 27th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053380774 | NPPES |
| Indiana | MEDICAID | 100088630 | |
| Indiana | Other | 9274775 | |
| Indiana | Other | 000000183094 | |
| Indiana | Other | 10825553 | |
| Indiana | MEDICAID | MA15766030 |
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