Provider Demographics
NPI:1366708745
Name:SIMMONS, ALETA (MD)
Entity type:Individual
Prefix:
First Name:ALETA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 CHARLOTTE PIKE # 712
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2926
Mailing Address - Country:US
Mailing Address - Phone:615-437-5001
Mailing Address - Fax:615-919-9937
Practice Address - Street 1:6339 CHARLOTTE PIKE # 721
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2926
Practice Address - Country:US
Practice Address - Phone:615-437-5001
Practice Address - Fax:615-919-9937
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58342207N00000X
ILBF4649604207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program