Provider Demographics
NPI:1982615068
Name:TRAXLER, WALTER THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:THOMAS
Last Name:TRAXLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3012 MILES DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4112
Mailing Address - Country:US
Mailing Address - Phone:405-348-9900
Mailing Address - Fax:
Practice Address - Street 1:LAWTON-FT. SILL VA OUTPATIENT CLINIC
Practice Address - Street 2:BLDG 4303 PITMAN AND THOMAS
Practice Address - City:FORT STILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-353-1131
Practice Address - Fax:580-353-0340
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK135162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry