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Organization

KERRY CHILDERS, O.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KERRY CHILDERS OD (OPTOMETRIC PHYSICIAN)
(870) 238-9407
Entity
Organization

Contact information

Practice address
618 JULIA AVE E, WYNNE, AR 72396-3504
(870) 238-9407
(870) 238-4320
Mailing address
PO BOX 562, WYNNE, AR 72396
(870) 238-9407
(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
110249722
AR
Enumeration date
02/22/2007
Last updated
04/06/2009
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