Provider Demographics
NPI:1992119465
Name:SIMS, STEPHANIE (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10380 HAZELNUT DR
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-2569
Mailing Address - Country:US
Mailing Address - Phone:614-886-3388
Mailing Address - Fax:
Practice Address - Street 1:12082 SYCAMORE TRACE
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-4400
Practice Address - Country:US
Practice Address - Phone:614-429-1101
Practice Address - Fax:614-633-1993
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6318152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist