Provider Demographics
NPI:1558628529
Name:SIMS, DOYLE DEWAYNE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOYLE
Middle Name:DEWAYNE
Last Name:SIMS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20 THICKET CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-4332
Mailing Address - Country:US
Mailing Address - Phone:904-673-8590
Mailing Address - Fax:
Practice Address - Street 1:4266 SUNBEAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-2425
Practice Address - Country:US
Practice Address - Phone:904-407-6378
Practice Address - Fax:904-407-6389
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 369061835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric