Provider Demographics
NPI:1356351712
Name:SIMS, JANENE (OD)
Entity type:Individual
Prefix:DR
First Name:JANENE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 UNIVERSITY BLVD
Mailing Address - Street 2:HPB G080A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1716 UNIVERSITY BLVD
Practice Address - Street 2:HPB G080A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-975-2020
Practice Address - Fax:205-934-6755
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS845TA375152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A1716636005396OtherVISION SERVICE PLAN
ALU76279OtherVIVA
AL51517963OtherBCBS
MS06708858Medicaid
AL000035145Medicaid
MS06708858Medicaid
AL1387505Medicare ID - Type UnspecifiedTRAVELER
AL000035145Medicaid
A1716636005396OtherVISION SERVICE PLAN