Provider Demographics
NPI:1396731816
Name:SIMS, LEWIS J (DO)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:J
Last Name:SIMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:211 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-1809
Mailing Address - Country:US
Mailing Address - Phone:570-366-1171
Mailing Address - Fax:570-366-0550
Practice Address - Street 1:211 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1809
Practice Address - Country:US
Practice Address - Phone:570-366-1171
Practice Address - Fax:570-366-0550
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002872L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00061859000Medicaid
PA00061859000Medicaid
PAE02330Medicare UPIN