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NPI Code Detail

MEDICARE: STEVEN KYLE SIMS H.I.S.

MEDICARE: STEVEN KYLE SIMS H.I.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistHAS-0531SC
2174400000XSpecialistHADS-872GA

General Provider Information

NPI Number : 1255708087
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN KYLE SIMS H.I.S.
Provider Business Mailing Address
First Line : 16 WILLIAM POPE DR
Second Line : SUITE 103
City : BLUFFTON
State : SC
Zip : 29909-7502
Country : US
Telephone Number : 843-707-1305
Fax Number : 843-707-1311
Provider Business Practice Location Address
First Line : 16 WILLIAM POPE DR
Second Line : SUITE 103
City : BLUFFTON
State : SC
Zip : 29909-7502
Country : US
Telephone Number : 843-707-1305
Fax Number : 843-707-1311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2015
Last Update Date : 08/27/2015

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