Tracey Way Childers, DO | |
1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | |
(918) 453-1234 | |
(918) 453-9107 |
Full Name | Tracey Way Childers |
---|---|
Gender | Female |
Speciality | Otolaryngology |
Experience | 30 Years |
Location | 1203 E Ross Byp, Tahlequah, Oklahoma |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053371021 | NPI | - | NPPES |
DA5295 | Other | OK | RAILROAD MEDICARE GROUP NUMBER |
P00027981 | Other | OK | RAILROAD MEDICARE PIN NUMBER |
200000030A | Medicaid | OK | |
100257460A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | 3296 (Oklahoma) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
Osf Saint Paul Medical Center | Mendota, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Osf Multi-specialty Group | 3678889789 | 1543 |
Entity Name | Osf Multi-specialty Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Tracey Way Childers, DO 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 Ph: (918) 453-1234 | Tracey Way Childers, DO 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 Ph: (918) 453-1234 |
Susan K Anderson, DO Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 Phone: 918-453-1234 Fax: 918-453-9107 | |
Lea Sarah Humphrey, D.O. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1203 E Ross Byp, Tahlequah, OK 74464 Phone: 918-453-1234 Fax: 918-453-9107 | |
Charles Joseph Wine, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464 Phone: 918-458-3360 Fax: 918-458-3511 |