Provider Demographics
NPI:1710091293
Name:WILLIAM HAYDEN CHILDS, MD, PC
Entity Type:Organization
Organization Name:WILLIAM HAYDEN CHILDS, MD, PC
Other - Org Name:CHILDS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULE
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-898-2728
Mailing Address - Street 1:98 E MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:SAMSON
Mailing Address - State:AL
Mailing Address - Zip Code:36477-1229
Mailing Address - Country:US
Mailing Address - Phone:334-898-2728
Mailing Address - Fax:334-898-2774
Practice Address - Street 1:98 E MORRIS ST
Practice Address - Street 2:
Practice Address - City:SAMSON
Practice Address - State:AL
Practice Address - Zip Code:36477-1229
Practice Address - Country:US
Practice Address - Phone:334-898-2728
Practice Address - Fax:334-898-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6999207R00000X, 207RP1001X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529924260Medicaid
ALDB2295OtherRAILROAD MEDICARE
AL529924260Medicaid
ALDB2295OtherRAILROAD MEDICARE