| Robert D Childers Md Sc | |
|
400 Maple Summit Rd Ste 300 Jerseyville IL 62052-2028 | |
| (618) 498-8470 | |
| (618) 498-8488 |
| Full Name | Robert D Childers Md Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 Maple Summit Rd, Jerseyville, Illinois |
| Authorized Official Name and Position | Robert Duncan Childers (PRESIDENT) |
| Authorized Official Contact | 6184988470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert D Childers Md Sc 400 Maple Summit Rd Ste 300 Jerseyville IL 62052-2028 Ph: (618) 498-8470 | Robert D Childers Md Sc 400 Maple Summit Rd Ste 300 Jerseyville IL 62052-2028 Ph: (618) 498-8470 |
| NPI Number | 1699962498 |
|---|---|
| Provider Enumeration Date | 09/26/2007 |
| Last Update Date | 02/25/2008 |
| Medicare PECOS PAC ID | 3274422563 |
|---|---|
| Medicare Enrollment ID | O20040315000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699962498 | NPI | - | NPPES |
| DG2287 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Robert D Childers |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1760477376 PECOS PAC ID: 7810886108 Enrollment ID: I20040316000090 |
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