Provider Demographics
NPI:1871587485
Name:SIMMS, DENNIS C (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:SIMMS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 POTTERSHOP RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-8330
Mailing Address - Country:US
Mailing Address - Phone:601-479-0239
Mailing Address - Fax:270-865-2012
Practice Address - Street 1:255 SCHOOL DR
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:KY
Practice Address - Zip Code:40037-8144
Practice Address - Country:US
Practice Address - Phone:270-865-2011
Practice Address - Fax:270-865-2012
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
73001635OtherBLUE CROSS OF AL
080145422OtherRAILROAD MEDICARE
009915310OtherMEDICAID OF AL
MS00114739Medicaid
KY7100213480Medicaid
MS00114739Medicaid