DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BRIAN BLAKE CHILDRESS PA

MEDICARE: BRIAN BLAKE CHILDRESS PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA3467TN

General Provider Information

NPI Number : 1740791847
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN BLAKE CHILDRESS PA
Provider Business Mailing Address
First Line : PO BOX 400
Second Line :
City : JACKSON
State : TN
Zip : 38302-0400
Country : US
Telephone Number : 731-422-0213
Fax Number : 731-660-8319
Provider Business Practice Location Address
First Line : 87 MURRAY GUARD DR STE B
Second Line :
City : JACKSON
State : TN
Zip : 38305-3775
Country : US
Telephone Number : 731-422-0213
Fax Number : 731-660-8319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2017
Last Update Date : 04/03/2026

Similar Medicare Providers

1750368932 — DR. ENID F BURNETT MD
Practice Location Address:
87 MURRAY GUARD DR STE B
JACKSON, TN
38305-3775
Practice Phone: 731-422-0213
Practice Fax: 731-660-8319
1962644013 — VIRGINIA ANNE KOUBEK M.D.
Practice Location Address:
87 MURRAY GUARD DR STE B
JACKSON, TN
38305-3775
Practice Phone: 731-664-1375
Practice Fax: 731-660-8319
1437386232 — EMILY T WOLFE MD
Practice Location Address:
87 MURRAY GUARD DR STE B
JACKSON, TN
38305-3775
Practice Phone: 731-422-0213
Practice Fax: 731-422-0475
1700266558 — BUCKLEY PARKER P.A.
Practice Location Address:
87 MURRAY GUARD DR STE B
JACKSON, TN
38305-3775
Practice Phone: 731-664-1375
Practice Fax: 731-660-8319
1235721267 — ERIN ELIZABETH FAIN NP-C
Practice Location Address:
87 MURRAY GUARD DR STE B
JACKSON, TN
38305-3775
Practice Phone: 731-422-0213
Practice Fax: 731-660-8319
1366382624 — BAYLEE BROOKE BRIDGES
Practice Location Address:
1050 UNION UNIVERSITY DR
JACKSON, TN
38305-3697
Practice Phone: 731-668-1818
Practice Fax:

Directions to “ BRIAN BLAKE CHILDRESS PA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.