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Organization

HARLEY'S ENDEAVORS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HEWATT MCGRAW SIMS MD (OWNER)
(229) 387-8061
Entity
Organization

Contact information

Practice address
1622 MADISON AVE, TIFTON, GA 31794-3756
(229) 387-8061
(229) 387-8064
Mailing address
1622 MADISON AVE, TIFTON, GA 31794-3756
(229) 387-8061
(229) 387-8064

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
209800000X
Legal Medicine (M.D./D.O.) Physician
332900000X
Non-Pharmacy Dispensing Site
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
05/08/2018
Last updated
07/07/2020
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