Childers, Jennifer W
Childers, Jennifer W is an sole proprietor health care provider with primary practice located at 3156 State St , Medford OR 97504-8450. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Childers, Jennifer W can be contacted via phone (541) 773-9772.Contact Information
Primary practice address
3156 State St
Medford OR 97504-8450
Phone: (541) 773-9772
Fax: (541) 773-9772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD17352 | Tennessee |
Profile Details
| NPI number | 1265515563 |
|---|---|
| LBN Legal business name | Childers, Jennifer W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Dec 16th, 2011 - about 13 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 | 1265515563 | NPPES |
| Oregon | MEDICAID | 500608995 |
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