Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 60903 | MN |
N | 111NI0900X | Internist | 60903 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 60903 | MN |
Y | 207RI0011X | Interventional Cardiology | 60903 | MN |
NPI | 1043699192 |
---|---|
Provider Name | Jason Sims |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2015 |
Last Update Date | 23/06/2021 |