Provider Demographics
NPI:1912102146
Name:SIMS CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:SIMS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-982-0988
Mailing Address - Street 1:500 EAST WOODROW WILSON AVE
Mailing Address - Street 2:STE F
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-982-0988
Mailing Address - Fax:601-982-4288
Practice Address - Street 1:500 EAST WOODROW WILSON AVE
Practice Address - Street 2:STE F
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-982-0988
Practice Address - Fax:601-982-4288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty