MEDICARE: DR. MARY CAROL SIMS M.D.

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
1	2084N0400X	Neurology Physician	8758	MT

General Provider Information

NPI Number	:	1114114220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY CAROL SIMS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 470126
Second Line	:	140 WEASEL CREEK RD
City	:	WINSTON
State	:	MT
Zip	:	59647-0126
Country	:	US
Telephone Number	:	406-992-0195
Fax Number	:	866-349-6549

Provider Business Practice Location Address
First Line	:	140 WEASEL CREEK RD
Second Line	:	BOX 470126
City	:	WINSTON
State	:	MT
Zip	:	59647-0126
Country	:	US
Telephone Number	:	406-992-0195
Fax Number	:	866-349-6549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	04/08/2009

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