Provider Demographics
NPI:1548619166
Name:SIMS, JENNIFER (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:233 N HOUSTON RD STE 140A
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3023
Mailing Address - Country:US
Mailing Address - Phone:478-975-6720
Mailing Address - Fax:478-975-6766
Practice Address - Street 1:233 N HOUSTON RD STE 140A
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3023
Practice Address - Country:US
Practice Address - Phone:478-923-2843
Practice Address - Fax:478-975-6766
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-04
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA010670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program