Provider Demographics
NPI:1639138837
Name:SIMS, RONALD SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:SCOTT
Last Name:SIMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 JOHN F KENNEDY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3883
Mailing Address - Country:US
Mailing Address - Phone:563-583-1558
Mailing Address - Fax:563-583-0443
Practice Address - Street 1:2140 JOHN F KENNEDY RD
Practice Address - Street 2:SUITE C
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3883
Practice Address - Country:US
Practice Address - Phone:563-583-1558
Practice Address - Fax:563-583-0443
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA274572084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7296137Medicaid
IAI17673Medicare PIN
IAE42102Medicare UPIN