Provider Demographics
NPI:1396940599
Name:HUGH SIMS MD PSC
Entity type:Organization
Organization Name:HUGH SIMS MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:270-782-7768
Mailing Address - Street 1:340 NEW TOWNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103
Mailing Address - Country:US
Mailing Address - Phone:270-782-7768
Mailing Address - Fax:270-781-9480
Practice Address - Street 1:340 NEW TOWNE DRIVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103
Practice Address - Country:US
Practice Address - Phone:270-782-7768
Practice Address - Fax:270-781-9480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2955P363L00000X
KY30304174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65930042Medicaid
KY5382Medicare PIN