Kerry Childers, O.D., P.A.

LBN: Kerry Childers, O.D., P.A.
Kerry Childers, O.D., P.A. is an health care organization with primary practice located at 618 Julia Ave E , Wynne AR 72396-3504. The organization recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as the primary health care specialty. Kerry Childers, O.D., P.A. can be contacted via phone (870) 238-9407, or through Childers, Kerry via phone (870) 238-9407.

Contact Information

Primary practice address
618 Julia Ave E Wynne AR 72396-3504
Phone: (870) 238-9407
Fax: (870) 238-4320
Website:
Map and Directions
Authorized official contact:
Name: Childers, Kerry Doctor of Optometry (OD)
Phone: (870) 238-9407

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 2038 Arkansas

Profile Details

NPI number 1568597409
LBN Legal business name Kerry Childers, O.D., P.A.
DBA Doing business as
Authorized official Childers, Kerry Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 22nd, 2007
Last updated Apr 6th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568597409 NPPES
Arkansas MEDICAID 110249722

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