Individual
DR. KERRY K CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
723 FALLS BLVD S, STE A, WYNNE, AR 72396-3508
(870) 238-2020
(870) 238-4320
Mailing address
723 FALLS BLVD S, STE A, WYNNE, AR 72396-3508
(870) 238-2020
(870) 238-4320
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2038
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102042722
—
AR
01
—
64772430001
PTAN
AR
Enumeration date
01/16/2006
Last updated
03/17/2015
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