Jack R Childress, MD is a medicare enrolled "Internal Medicine" physician in Lake Kiowa, Texas. His current practice location is
105 Sequoya Dr, Lake Kiowa, Texas. You can reach out to his office (for appointments etc.) via phone at
(940) 736-8885.
Jack R Childress is licensed to practice in Texas (license number H5535) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841245883.
Physician's Profile
| Full Name | Jack R Childress |
|---|
| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 105 Sequoya Dr, Lake Kiowa, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jack R Childress attended and graduated from in
NPI Data:
- NPI Number: 1841245883
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 12/29/2023
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Jack R Childress such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841245883 | NPI | - | NPPES |
| 8V4246 | Other | TX | BCBS-TEXAS |
| 163713001 | Medicaid | AR | |
| 1140766-07 | Medicaid | TX | |
| 84487 | Other | AR | BCBS-ARKANSAS |
| P00466537 | Other | TX | RR MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208M00000X | Hospitalist | H5535 (Texas) | Secondary |
| 207R00000X | Internal Medicine | H5535 (Texas) | Primary |
| 207R00000X | Internal Medicine | 14502A (Wyoming) | Secondary |
| 207R00000X | Internal Medicine | 97208 (Georgia) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack R Childress is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack R Childress, MD
105 Sequoya Dr,
Lake Kiowa, TX 76240-9446
Ph: (940) 736-8885 | Jack R Childress, MD
105 Sequoya Dr,
Lake Kiowa, TX 76240-9446
Ph: (940) 736-8885 |
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