Healthcare Provider Details

I. General information

NPI: 1013240118
Provider Name (Legal Business Name): TARA JACQUELIN CLAUSSEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S US HIGHWAY 59
PARSONS KS
67357-4948
US

IV. Provider business mailing address

3100 MEDICAL PKWY STE 100
CLAREMORE OK
74017-1088
US

V. Phone/Fax

Practice location:
  • Phone: 620-421-4880
  • Fax:
Mailing address:
  • Phone: 918-341-1000
  • Fax: 918-293-3141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0547352
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: