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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