Champion, John Edward
Champion, John Edward is an individual health care provider with primary practice located at 800 8Th Ave Suite 532, Fort Worth TX 76104-2604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is his primary health care specialty. Champion, John Edward can be contacted via phone (817) 335-4005.Contact Information
Primary practice address
800 8Th Ave Suite 532
Fort Worth TX 76104-2604
Phone: (817) 335-4005
Fax: (817) 332-3369
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | E2505 | Texas |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207QA0000X | E2505 | Texas |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207RA0000X | E2505 | Texas |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | E2505 | Texas |
Profile Details
| NPI number | 1275582439 |
|---|---|
| LBN Legal business name | Champion, John Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2006 |
| Last updated | Jul 1st, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275582439 | NPPES |
| Texas | Other | 132990609 | TEXAS HEALTH STEPS |
| Texas | MEDICAID | 132990602 | TEXAS HEALTH STEPS |
| Texas | Other | 4019283 | TEXAS HEALTH STEPS |
| Texas | Other | 00TD97 | TEXAS HEALTH STEPS |
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