Provider Demographics
NPI:1669836532
Name:SIMS, DANIEL REID (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:REID
Last Name:SIMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:395 W COUGAR BLVD
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3311
Practice Address - Country:US
Practice Address - Phone:801-357-0775
Practice Address - Fax:801-357-0771
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16040207R00000X, 208M00000X
390200000X
UT13381040-1204207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program