Provider Demographics
NPI:1295843910
Name:CHILDS, DONNA S (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:CHILDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 MISSION RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1355
Mailing Address - Country:US
Mailing Address - Phone:913-341-7447
Mailing Address - Fax:913-341-7262
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:SUITE 230
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1355
Practice Address - Country:US
Practice Address - Phone:913-341-7447
Practice Address - Fax:913-341-7262
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-123752084P0800X
MOR30842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000315Medicare ID - Type Unspecified
D93757Medicare UPIN