Gary Lynn Childers DO

NPI 1073606679 - Internal Medicine - 207R00000X

NPI Details
NPI 1073606679
Gender Male
Enumeration Date 10/02/2006
Last Updated 02/06/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
1420 N 10TH ST
SPEARFISH SD, 57783, US
Phone (605) 642-8414
Fax (605) 642-8618
Business Location
353 FAIRMONT BLVD
ATTEN MEDICAL STAFF SERVICES
RAPID CITY SD, 57701-6000, US
Phone
Fax
Toxanomy
Taxonomy Code 207R00000X
License State South Dakota
License Number 4474
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According to our database, Gary Lynn Childers DO NPI is 1073606679, taxonomy code is 207R00000X and license number is 4474, license state is located at South Dakota. Gary Lynn Childers DO physically located at 1420 N 10th St, Spearfish SD, 57783. NPI Number Gary Lynn Childers DO has the Individual type.

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1073606679 NPI number is provided on an as is basis without warranty of any kind. 1073606679 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Lynn Childers DO are for informational purposes only.