Individual
DR. JEFFREY W CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 S MOUNT AUBURN RD, SUITE 342, CAPE GIRARDEAU, MO 63703-4910
(573) 335-2212
(573) 339-5946
Mailing address
150 S MOUNT AUBURN RD, SUITE 342, CAPE GIRARDEAU, MO 63703-4910
(573) 335-2212
(573) 339-5946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2001004971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205303019
—
MO
Enumeration date
10/10/2006
Last updated
07/09/2007
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