Provider Demographics
NPI:1912900853
Name:CHILDERS, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:CHILDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:115 CROSSFIELD DR
Mailing Address - Street 2:STE A
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1845
Mailing Address - Country:US
Mailing Address - Phone:859-873-9843
Mailing Address - Fax:859-873-0972
Practice Address - Street 1:115 CROSSFIELD DR
Practice Address - Street 2:STE A
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1845
Practice Address - Country:US
Practice Address - Phone:859-873-9843
Practice Address - Fax:859-873-0972
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-01-18
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Provider Licenses
StateLicense IDTaxonomies
KY21525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047822OtherANTHEM BCBS
KY110031154OtherRAILROAD MEDICARE
KY0400353OtherUNITED HEALTHCARE
KY0037679OtherMEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
KY1404232OtherUMWA
KY611012421004OtherTRICARE
KY64100696OtherMEDICAID - FAYETTE COUNTY HEALTH DEPARTMENT
KY64215254Medicaid
KY1284109OtherUMWA
KY611012421EOtherHUMANA HMO
KY64215254Medicaid
KY611012421004OtherTRICARE
KY0037679OtherMEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT