Provider Demographics
NPI:1851330310
Name:SIMMS, SULTAN JABARI (MD)
Entity Type:Individual
Prefix:
First Name:SULTAN
Middle Name:JABARI
Last Name:SIMMS
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:PO BOX 44281
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30336-1281
Mailing Address - Country:US
Mailing Address - Phone:404-861-4085
Mailing Address - Fax:770-969-4337
Practice Address - Street 1:3455 N DESERT DR
Practice Address - Street 2:BUILDING 3, SUITE 106
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-5725
Practice Address - Country:US
Practice Address - Phone:404-768-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0559752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry