MEDICARE: DR. GEORGE JOSEPH CHILDS MD

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
1	208600000X	Surgery Physician	ME89270	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	271669	OTHER	FL	AMERIGROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	37679	OTHER	FL	BCBSFL PROVIDER NUMBER
4	2193121	OTHER	FL	CIGNA
5	373337	OTHER	FL	UNITED HEALTHCARE
6	228678	OTHER	FL	WELLCARE

General Provider Information

NPI Number	:	1932109303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE JOSEPH CHILDS MD

Provider Business Mailing Address
First Line	:	250 2ND ST E
Second Line	:	SUITE 4F
City	:	BRADENTON
State	:	FL
Zip	:	34208-1029
Country	:	US
Telephone Number	:	941-747-8404
Fax Number	:	941-747-0773

Provider Business Practice Location Address
First Line	:	250 2ND ST E
Second Line	:	SUITE 4F
City	:	BRADENTON
State	:	FL
Zip	:	34208-1029
Country	:	US
Telephone Number	:	941-747-8404
Fax Number	:	941-747-0773

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/24/2008

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