Healthcare Provider Details

I. General information

NPI: 1366403537
Provider Name (Legal Business Name): CLAUDIA PEREZ-TAMAYO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W 12TH AVE
EMPORIA KS
66801-2570
US

IV. Provider business mailing address

PO BOX 256
SALINA KS
67402-0256
US

V. Phone/Fax

Practice location:
  • Phone: 620-342-1117
  • Fax: 855-774-5285
Mailing address:
  • Phone: 785-823-0633
  • Fax: 785-823-0658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number2009001463
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number04-22993
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: