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KERRY CHILDERS O.D. P.A. NPI 1568597409


NPI Information

NPI: 1568597409
Provider Name: KERRY CHILDERS, O.D., P.A.
Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
618 JULIA AVE E
WYNNE, AR
ZIP 72396
Phone: (870) 238-9407
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KERRY CHILDERS, O.D., P.A. is a corneal and contact management optometrist in Wynne, AR. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. KERRY CHILDERS, O.D., P.A. NPI is 1568597409. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

618 JULIA AVE E
WYNNE, AR
ZIP 72396-504
Phone: (870) 238-9407
Fax: (870) 238-4320

The provider's authorized official is Kerry Childers .
The authorized official title is Optometric Physician and has the following contact phone number (870) 238-9407.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 4/6/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WC0802XOptometristCorneal and Contact Management2038ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10335220001MEDICARE NSCARKANSAS
25C990MEDICARE PINARKANSAS
35C990MEDICARE ID-TYPE UNSPECIFIEDARKANSASBCBS GROUP
4110249722MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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