Individual
LARRY SIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
900 E WOODLAND AVE, KNOXVILLE, TN 37917-4511
(865) 633-9469
(865) 633-9474
Mailing address
900 E WOODLAND AVE, KNOXVILLE, TN 37917-4511
(865) 633-9469
(865) 633-9474
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1707
TN
363A00000X
Physician Assistant
TL1298
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9104089
PA MEDICAL LICENSE
FL
01
—
TL1298
SC LICENSE
SC
Enumeration date
02/26/2007
Last updated
06/15/2010
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