National Provider Identifier Database

KENNETH CHILDERS P A
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

KENNETH CHILDERS P A
611 S MT OLIVE
SILOAM SPRINGS, AR72761
Phone: 479-524-4231
Fax: 479-524-8850
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for KENNETH CHILDERS P A

NPI Number 1407069487
Legal business name
LBN
KENNETH CHILDERS P A
Authorized official KENNETH CHILDERS - (OPTOMETRIST)
Entity Organization
Organization subpart No
Enumeration date 05/07/2007
Last updated 10/08/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: 2039
  • AR Medicaid: 139158722
  • AR Other: 5G041 MEDICARE GROUP PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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