| Doctor Name: | TRACEY WAY CHILDERS |
| NPI Number: | 1053371021 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 3296 |
| Business Practice Address: | 1203 E Ross Byp Suite A Tahlequah, OK - 744644188 |
| Business Phone Number: | 9184531234 |
| Business Fax Number: | 9184539107 |
| Mailing Address: | 1203 E Ross Byp, Suite A TAHLEQUAH |
| State: | OK |
| Postal Code: | 744644188 |
| Phone Number: | 9184531234 |
| Fax Number: | 9184539107 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 03/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0905X |
| License Number: | 3296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |