C. Edwin Childers, Jr., Md, Pllc

LBN: C. Edwin Childers, Jr., Md, Pllc
C. Edwin Childers, Jr., Md, Pllc is an health care organization with primary practice located at 4607 Maccorkle Ave Sw Mp Ste 204, South Charleston WV 25309-1364. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. C. Edwin Childers, Jr., Md, Pllc can be contacted via phone (304) 767-7930, or through Childers, Clark Edwin via phone (304) 767-7930.

Contact Information

Primary practice address
4607 Maccorkle Ave Sw Mp Ste 204 South Charleston WV 25309-1364
Phone: (304) 767-7930
Fax: (304) 767-7935
Website:
Map and Directions
Authorized official contact:
Name: Childers, Clark Edwin Doctor of Medicine (MD)
Phone: (304) 767-7930

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 18115 West Virginia

Profile Details

NPI number 1841408978
LBN Legal business name C. Edwin Childers, Jr., Md, Pllc
DBA Doing business as
Authorized official Childers, Clark Edwin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2007
Last updated Aug 22nd, 2020 - about 5 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 1841408978 NPPES
West Virginia MEDICAID 0109655000

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