Provider Demographics
NPI:1649262049
Name:SIMS, GERALD N JR (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:N
Last Name:SIMS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:811 E PARRISH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3258
Practice Address - Country:US
Practice Address - Phone:270-688-5100
Practice Address - Fax:270-688-5109
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY30326207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100385270Medicaid
KY6430326600Medicaid
KY6430326600Medicaid
KY3397737Medicare PIN
KY6430326600Medicaid
KY3397737Medicare PIN