HomeNPI Verification

NPI Verification

National Provider Identifier: 1841245883

Jack R Childress, MD

Individual Provider

Credentials

Primary Specialty

Internal Medicine

Code: 207R00000X

All Specialties (5)

Internal Medicine

Code: 207R00000X

Internal Medicine

Code: 207R00000X

Internal Medicine

Code: 207R00000X

Hospitalist

Code: 208M00000X

Internal Medicine

Code: 207R00000X

Primary

Practice Address

105 SEQUOYA DR

LAKE KIOWA, TX 762409446

Phone: 940-736-8885

NPI Enumeration Date

May 24, 2006

NPI Number

1841245883

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry