Provider Demographics
NPI:1477931871
Name:CHILDERS, KERI ALISON (DO)
Entity type:Individual
Prefix:DR
First Name:KERI
Middle Name:ALISON
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:405 W GRAND AVE
Mailing Address - Street 2:MEDICAL EDUCATION DEPARTMENT
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4720
Mailing Address - Country:US
Mailing Address - Phone:937-723-3245
Mailing Address - Fax:937-723-5017
Practice Address - Street 1:405 W GRAND AVE
Practice Address - Street 2:MEDICAL EDUCATION DEPARTMENT
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4720
Practice Address - Country:US
Practice Address - Phone:937-723-3245
Practice Address - Fax:937-723-5017
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.012404207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine