Individual
DR. DAVID OMER CHILDERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6271 SAINT AUGUSTINE RD, UFJP DEVELOPMENTAL PEDIATRICS, JACKSONVILLE, FL 32217-2523
(904) 633-0770
(904) 633-0751
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME86363
FL
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
ME86363
FL
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
ME86363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000975301A
—
GA
05
—
2658267-00
—
FL
Enumeration date
06/10/2006
Last updated
12/13/2019
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