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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134157605 | NPPES |
| Florida | MEDICAID | PENDING | |
| Florida | Other | PENDING |
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