Organization
THE KID DOCTOR PC
Active
Other names
Brian Keith Childers MD
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLIE VOORHEES (MANAGER)
(912) 383-4352
Entity
Organization
Contact information
Practice address
100 DOCTORS DR, SUITE 104, DOUGLAS, GA 31533-2210
(912) 383-4352
(912) 384-1192
Mailing address
100 DOCTORS DR, SUITE 104, DOUGLAS, GA 31533-2210
(912) 383-4352
(912) 384-1192
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042212
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000718792E
—
GA
Enumeration date
09/09/2008
Last updated
09/09/2008
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