Childress, John M.

Childress, John M. is an individual health care provider with primary practice located at 550 1St Ave , New York NY 10016-6402. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Childress, John M. can be contacted via phone (212) 263-3293.

Contact Information

Primary practice address
550 1St Ave New York NY 10016-6402
Phone: (212) 263-3293
Fax: (212) 263-3522
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME95727 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35 123788 Ohio
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME 95727 Florida
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X ME 95727 Florida

Profile Details

NPI number 1134157605
LBN Legal business name Childress, John M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Mar 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134157605 NPPES
Florida MEDICAID PENDING
Florida Other PENDING

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