Healthcare Provider Details

I. General information

NPI: 1376953653
Provider Name (Legal Business Name): TRAVIS SIMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 HARRISON ST
BATESVILLE AR
72501-7303
US

IV. Provider business mailing address

16 HOSPITAL CIR STE A
BATESVILLE AR
72501-7343
US

V. Phone/Fax

Practice location:
  • Phone: 870-262-1200
  • Fax:
Mailing address:
  • Phone: 870-793-5504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-10251
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: