Individual
DR. RICHARD DALE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5659 S REX RD, MEMPHIS, TN 38119-3821
(901) 763-3636
(901) 763-3694
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5800
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
19582
MS
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
39115
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00447294
MEDICARE RAILROAD
—
Enumeration date
02/20/2006
Last updated
10/25/2016
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