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TRACEY W. CHILDERS D.O. P.C. NPI 1720274699


NPI Information

NPI: 1720274699
Provider Name: TRACEY W. CHILDERS, D.O. P.C.

Doing Business As: CHILDERS MEDICAL GROUP

Classification: Otolaryngology - 207Y00000X
Entity Type: Organization
Address:
1203 E ROSS BYP
SUITE A
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 453-1234
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TRACEY W. CHILDERS, D.O. P.C. is an otolaryngology in Tahlequah, OK. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. TRACEY W. CHILDERS, D.O. P.C. NPI is 1720274699. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Childers Medical Group.

The provider's business location address is:

1203 E ROSS BYP
SUITE A
TAHLEQUAH, OK
ZIP 74464-188
Phone: (918) 453-1234
Fax: (918) 453-9107

The provider's authorized official is Tracey W Childers .
The authorized official title is Medical Director and has the following contact phone number (918) 453-1234.

The enumeration date for this NPI number is 9/24/2007 and was last updated on 9/15/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Y00000XOtolaryngology3296OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200000030AMEDICAIDOKLAHOMA
2400522239MEDICARE PINOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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