Doctor Name: | SHARON RENEE SIMMS |
NPI Number: | 1649481854 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RT |
License Number: | 288546 |
Business Practice Address: | 301 Boulder Dr Haughton, LA - 710378955 |
Business Phone Number: | 3182184043 |
Business Fax Number: | |
Mailing Address: | 301 Boulder Dr, HAUGHTON |
State: | LA |
Postal Code: | 710378955 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471C3401X |
License Number: | 288546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Computed Tomography |
Taxonomy Definition: |