Individual
DR. HEBER GRANT SIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
353A E BLACKSTOCK RD, SPARTANBURG, SC 29301-3762
(864) 574-0366
(864) 574-0367
Mailing address
353A E BLACKSTOCK RD, SPARTANBURG, SC 29301-3762
(864) 574-0366
(864) 574-0367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
565
SC
152WC0802X
Corneal and Contact Management Optometrist
Primary
565
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DO5652
—
SC
01
—
P00607240
RAILROAD
SC
01
—
T244250281
MEDICARE PTAN
SC
Enumeration date
07/05/2005
Last updated
08/08/2012
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