Individual
DR. JISON SIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-4154
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-4154
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102202118
VA
207RR0500X
Rheumatology Physician
Primary
0102202118
VA
Other
Enumeration date
07/11/2007
Last updated
10/03/2013
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