Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 5456 | AL |
NPI | 1003970922 |
---|---|
Provider Name | Dr. Hoyt Abner Childs JR. |
First Address | Owens Cross Roads, AL 35763-0369 |
Second Address | Boaz, AL 35957-0758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51500372 | BCBS OF ALABAMA (01) | AL |
C76598 | (02) | AL |