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General NPI Number Information
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NPI Number | 1831163740
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Entity Type | Individual
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Provider Name | DOUGLAS M CHILDS DPM
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 202 N PARK AVE SUITE 500
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City | APOPKA
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State | FL
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Zip | 32703
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Country | US
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Telephone | 407-410-1234
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Fax | 407-410-0149
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Provider Business Mailing Address
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Address Line | 3165 MCCRORY PL SUITE 174
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City | ORLANDO
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State | FL
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Zip | 32803-3771
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Country | US
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Telephone | 407-423-1234
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Fax | 407-517-1040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO 2841
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License Number State | FL
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