Healthcare Provider Details

I. General information

NPI: 1942681333
Provider Name (Legal Business Name): ANDREW D SIMS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 PLEASANT ST STE 300
DES MOINES IA
50309
US

IV. Provider business mailing address

1200 PLEASANT ST SOUTH 2 ROOM 236
DES MOINES IA
50309-1406
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-8923
  • Fax: 515-241-6497
Mailing address:
  • Phone: 515-241-6228
  • Fax: 515-241-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR-10371
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO-05159
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: