Provider Demographics
NPI:1710926704
Name:SIMMS, SHERYL L (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:L
Last Name:SIMMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4960 S GILBERT RD STE 11
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5982
Mailing Address - Country:US
Mailing Address - Phone:480-802-7170
Mailing Address - Fax:480-802-3812
Practice Address - Street 1:4960 S GILBERT RD STE 11
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5982
Practice Address - Country:US
Practice Address - Phone:480-802-7170
Practice Address - Fax:480-802-3812
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU58664Medicare UPIN