Provider Demographics
NPI:1053602185
Name:SIMS, WILLIAM SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:SIMS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 W CONNELL AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-4607
Mailing Address - Country:US
Mailing Address - Phone:918-335-7410
Mailing Address - Fax:
Practice Address - Street 1:3609 MAPLE RIDGE CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8904
Practice Address - Country:US
Practice Address - Phone:405-982-8130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant