Childress, Susan Boackle

Childress, Susan Boackle is an individual health care provider with primary practice located at 12605 E 16Th Ave , Aurora CO 80045-2545. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Childress, Susan Boackle can be contacted via phone (720) 848-0000.

Contact Information

Primary practice address
12605 E 16Th Ave Aurora CO 80045-2545
Phone: (720) 848-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 35598 Colorado
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X H7909 Texas
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X MD.43902 Alabama
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 335634 Louisiana
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X CDRH.0035598 Colorado

Profile Details

NPI number 1235229915
LBN Legal business name Childress, Susan Boackle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated May 9th, 2023 - about 2 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 1235229915 NPPES
Colorado MEDICAID 01355981

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