Provider Demographics
NPI:1497737233
Name:ROY L SIMS MD PC
Entity Type:Organization
Organization Name:ROY L SIMS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:205-221-7301
Mailing Address - Street 1:3400 HIGHWAY 78 E
Mailing Address - Street 2:SUITE 316 MEDICAL ARTS TOWER
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-8956
Mailing Address - Country:US
Mailing Address - Phone:205-221-7301
Mailing Address - Fax:205-221-7394
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:SUITE 316 MEDICAL ARTS TOWER
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8956
Practice Address - Country:US
Practice Address - Phone:205-221-7301
Practice Address - Fax:205-221-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9740174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC75007Medicare UPIN