Provider Demographics
NPI:1275521197
Name:ART, CHILDS R (MD)
Entity Type:Individual
Prefix:
First Name:CHILDS
Middle Name:R
Last Name:ART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 HOSPITAL AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2550
Mailing Address - Country:US
Mailing Address - Phone:413-663-8365
Mailing Address - Fax:413-662-2363
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2550
Practice Address - Country:US
Practice Address - Phone:413-663-8365
Practice Address - Fax:413-662-2363
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2011-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA215667208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0199249Medicaid
VT1009408Medicaid
MA0199249Medicaid
MAA34449Medicare PIN