Provider Demographics
NPI:1851383954
Name:SIMS, MOLLY R (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:R
Last Name:SIMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3591 RIDGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1875
Mailing Address - Country:US
Mailing Address - Phone:478-475-1006
Mailing Address - Fax:478-475-0787
Practice Address - Street 1:3591 RIDGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1875
Practice Address - Country:US
Practice Address - Phone:478-475-1006
Practice Address - Fax:478-475-0787
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA054512208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7454625OtherAETNA PPO
GA37BBGXKMedicare ID - Type UnspecifiedMEDICARE NUMBER
GAI35770Medicare UPIN