Provider Demographics
NPI:1023170925
Name:SIMS, CLIFFORD WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:WILLIAM
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 1:1407 UNION AVE STE 901
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3672
Mailing Address - Country:US
Mailing Address - Phone:901-526-8393
Mailing Address - Fax:901-526-8331
Practice Address - Street 1:1407 UNION AVE STE 901
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3672
Practice Address - Country:US
Practice Address - Phone:901-526-8393
Practice Address - Fax:901-526-8331
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10502207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3163225Medicaid
TN3163225Medicaid
TN3387359Medicare ID - Type Unspecified