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General NPI Number Information
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NPI Number | 1689844805
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Entity Type | Organization
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Legal Business Name | ANDREA D SIMS OD PC
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1320 HIGHWAY 78 E
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City | JASPER
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State | AL
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Zip | 35501-3965
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Country | US
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Telephone | 205-221-3937
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Fax | 205-221-4417
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Provider Business Mailing Address
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Address Line | 1320 HIGHWAY 78 E
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City | JASPER
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State | AL
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Zip | 35501-3965
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Country | US
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Telephone | 205-221-3937
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Fax | 205-221-4417
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Authorized Official
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Title or Position | OWNER PRESIDENT DOCTOR
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Name | DR. ANDREA D SIMS
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Credential | OD
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Telephone | 205-221-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5618TA131
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License Number State | AL
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