Healthcare Provider Details

I. General information

NPI: 1013096056
Provider Name (Legal Business Name): KLAMATH RADIOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 DAGGETT AVE
KLAMATH FALLS OR
97601-7101
US

IV. Provider business mailing address

2900 DAGGETT AVE
KLAMATH FALLS OR
97601-7101
US

V. Phone/Fax

Practice location:
  • Phone: 541-884-1371
  • Fax: 541-882-3862
Mailing address:
  • Phone: 541-884-1371
  • Fax: 541-882-3862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM K TAMPLEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 541-884-1371