Childers, Tracey Way

Childers, Tracey Way is an sole proprietor health care provider with primary practice located at 1203 E Ross Byp Suite A, Tahlequah OK 74464-4188. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as her primary health care specialty. Childers, Tracey Way can be contacted via phone (918) 453-1234.

Contact Information

Primary practice address
1203 E Ross Byp Suite A Tahlequah OK 74464-4188
Phone: (918) 453-1234
Fax: (918) 453-9107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 3296 Oklahoma

Profile Details

NPI number 1053371021
LBN Legal business name Childers, Tracey Way
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2006
Last updated May 28th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053371021 NPPES
Oklahoma Other DA5295 RAILROAD MEDICARE GROUP NUMBER
Oklahoma Other P00027981 RAILROAD MEDICARE GROUP NUMBER
Oklahoma MEDICAID 200000030A RAILROAD MEDICARE GROUP NUMBER
Oklahoma MEDICAID 100257460A RAILROAD MEDICARE GROUP NUMBER

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