Provider Demographics
NPI:1407957087
Name:SIMS, CAROLYN M (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:SIMS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:835 COGBURN AVE NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1031
Mailing Address - Country:US
Mailing Address - Phone:770-422-5557
Mailing Address - Fax:770-422-5456
Practice Address - Street 1:835 COGBURN AVE NW
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1031
Practice Address - Country:US
Practice Address - Phone:770-422-5557
Practice Address - Fax:770-422-5456
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA003784363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00380755OtherRAILROAD MEDICARE
GA97WCFPBMedicare PIN
GAP54430Medicare UPIN