Healthcare Provider Details

I. General information

NPI: 1235768276
Provider Name (Legal Business Name): OLIVER TODD TAMIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BRYANT WILLIAMS DR STE 1
KLAMATH FALLS OR
97601-1121
US

IV. Provider business mailing address

2200 BRYANT WILLIAMS DR STE 1
KLAMATH FALLS OR
97601-1121
US

V. Phone/Fax

Practice location:
  • Phone: 541-884-7746
  • Fax:
Mailing address:
  • Phone: 541-884-7746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDO230493
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: