Childress, Richard Dale

Childress, Richard Dale is an individual health care provider with primary practice located at 5659 S Rex Rd , Memphis TN 38119-3821. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Childress, Richard Dale can be contacted via phone (901) 763-3636.

Contact Information

Primary practice address
5659 S Rex Rd Memphis TN 38119-3821
Phone: (901) 763-3636
Fax: (901) 763-3694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 39115 Tennessee
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 19582 Mississippi

Profile Details

NPI number 1578538070
LBN Legal business name Childress, Richard Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Oct 25th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578538070 NPPES
Other P00447294 MEDICARE RAILROAD

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