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Individual
ELIZABETH CHILDRESS WESTERN
Active
Individual
ELIZABETH CHILDRESS WESTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30931
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102G701388
MEDICARE-GROUP
AL
01
—
102I081387
MEDICARE-INDIV.
AL
01
—
138413
MEDICAID-GROUP
AL
01
—
138652
MEDICAID INDIV.
AL
01
—
511-27182
BC/BS OF AL
AL
Enumeration date
12/17/2009
Last updated
07/30/2026
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