Dr. Blake G. Simmons, O.D.
Optometrist in Colorado Springs, CO. Individual provider (NPI-1).
NPI number1003909482
StatusActive
Last updated in NPPESMar 9, 2017
Details
- NPI
- 1003909482
- Entity type
- Individual (NPI-1)
- Name
- Dr. Blake G. Simmons
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2006
- Last updated
- Mar 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT-2588 | CO | Yes |
| 152W00000X | Optometrist | 1756 | KS |
Practice location
320 E Fontanero St Ste 201Colorado Springs, CO 80907-7525
Phone 719-559-2020 · Fax 719-623-6088
Mailing address
320 E Fontanero St Ste 201Colorado Springs, CO 80907-7525
Phone 719-559-2020 · Fax 719-623-6088
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