Individual
BRIAN BLAKE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
87 MURRAY GUARD DR STE B, JACKSON, TN 38305-3775
(731) 422-0213
(731) 660-8319
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 422-0213
(731) 660-8319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3467
TN
Other
Enumeration date
10/16/2017
Last updated
04/03/2026
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