Doctor Name: | DR. KERRY K CHILDERS |
NPI Number: | 1114906310 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 2038 |
Business Practice Address: | 723 Falls Blvd S Ste A Wynne, AR - 723963508 |
Business Phone Number: | 8702382020 |
Business Fax Number: | 8702384320 |
Mailing Address: | 723 Falls Blvd S, Ste A WYNNE |
State: | AR |
Postal Code: | 723963508 |
Phone Number: | 8702382020 |
Fax Number: | 8702384320 |
NPI Enumeration Date: | 01/16/2006 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 2038 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |