Individual
JEFFREY BRENNON CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 FALSTAFF RD, RALEIGH, NC 27610-1813
(919) 250-3133
(919) 250-1176
Mailing address
1028 COWPER DR, RALEIGH, NC 27608-2229
(919) 368-3522
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200500692
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902475
—
NC
Enumeration date
10/17/2006
Last updated
10/30/2023
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