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Individual

MR. HIRAM P. CHILDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
631 PROFESSIONAL DR, SUITE 360, LAWRENCEVILLE, GA 30045
(770) 962-4895
(770) 962-4792
Mailing address
631 PROFESSIONAL DR, SUITE 360, LAWRENCEVILLE, GA 30046
(770) 962-4895
(770) 962-4792

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100001620C
GA
Enumeration date
04/26/2007
Last updated
02/08/2010
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