Individual
DR. NICHOLAS CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
138 N LAKESIDE CT, RICHLAND, MS 39218-9793
(601) 813-6827
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5065
MS
Other
Enumeration date
03/27/2023
Last updated
07/03/2023
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