Dr Clark Edwin Childers Jr, MD in South Charleston, WV

Dr Clark Edwin Childers Jr, MD is a medicare enrolled "Pediatrics" physician in South Charleston, West Virginia. His current practice location is 4607 Maccorkle Ave Sw, Mp Ste 204, South Charleston, West Virginia. You can reach out to his office (for appointments etc.) via phone at (304) 767-7930.

Dr Clark Edwin Childers Jr is licensed to practice in West Virginia (license number 18115) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184793150.

Contact Information

	Dr Clark Edwin Childers Jr, MD
	4607 Maccorkle Ave Sw, Mp Ste 204, South Charleston, WV 25309-1364
	(304) 767-7930
	(304) 767-7935

Map and Direction

Physician's Profile

Full Name	Dr Clark Edwin Childers Jr
Gender	Male
Speciality	Pediatrics
Location	4607 Maccorkle Ave Sw, South Charleston, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184793150
Provider Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 6305293762
Enrollment ID: I20231107003761

Medical Identifiers

Medical identifiers for Dr Clark Edwin Childers Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184793150	NPI	-	NPPES
0109655000	Medicaid	WV

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	18115 (West Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Clark Edwin Childers Jr allows following entities to bill medicare on his behalf.

Entity Name	Ths Physician Partners Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871866806 PECOS PAC ID: 9537316393 Enrollment ID: O20120829000738

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Clark Edwin Childers Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Clark Edwin Childers Jr, MD 4607 Maccorkle Ave Sw, Mp Ste 204, South Charleston, WV 25309-1364 Ph: (304) 767-7930	Dr Clark Edwin Childers Jr, MD 4607 Maccorkle Ave Sw, Mp Ste 204, South Charleston, WV 25309-1364 Ph: (304) 767-7930

Reviews and Comments

Pediatrics Doctors in South Charleston, WV

Dr. Kara Michelle White, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 4607 Maccorkle Ave Sw, Ste 400, South Charleston, WV 25309 Phone: 304-766-4400 Fax: 304-766-4417
Melanie Anne Winnings, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4607 Maccorkle Ave, Ste 400, South Charleston, WV 25309 Phone: 304-766-4400 Fax: 304-766-4417
Nirali Jayantilal Borad, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600
Sharmila Matcheswalla Jones, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4607 Maccorkle Ave, Ste 400, South Charleston, WV 25309 Phone: 304-766-4400 Fax: 304-766-4417
Gilbert Goliath, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4607 Maccorkle Ave Sw Ste 400, South Charleston, WV 25309 Phone: 304-766-3988 Fax: 304-766-3984
Surya N Gupta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4803 Kentucky Street, Camc Pediatric Neurology, South Charleston, WV 25309 Phone: 304-766-7695 Fax: 603-663-3229

Dr Clark Edwin Childers Jr, MD - Medicare Pediatrics in South Charleston, WV