Provider Demographics
NPI:1487970521
Name:SIMON, BALA M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BALA
Middle Name:M
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:APPATHURAI
Other - Middle Name:
Other - Last Name:BALAMURUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT 530
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-6606
Practice Address - Fax:501-686-6594
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7295207Q00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program