Provider Demographics
NPI:1992786636
Name:SIMS, ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
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:P.O. BOX 518
Mailing Address - Street 2:
Mailing Address - City:HENAGAR
Mailing Address - State:AL
Mailing Address - Zip Code:35978
Mailing Address - Country:US
Mailing Address - Phone:256-657-1101
Mailing Address - Fax:256-657-1115
Practice Address - Street 1:18324 ALABAMA HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:HENAGAR
Practice Address - State:AL
Practice Address - Zip Code:35978
Practice Address - Country:US
Practice Address - Phone:256-657-1101
Practice Address - Fax:256-657-1115
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00024870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051522432Medicaid
ALH81745Medicare UPIN
AL051522432Medicaid