Individual
DR. JERRY C CHILDS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1520 MORNING STAR, EDMOND, OK 73034-6579
(405) 659-8840
Mailing address
1520 MORNING STAR, EDMOND, OK 73034-6579
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2157
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089890A
—
OK
Enumeration date
05/02/2006
Last updated
03/17/2018
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