Provider Demographics
NPI:1366403537
Name:PEREZ-TAMAYO, CLAUDIA (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:
Last Name:PEREZ-TAMAYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67402-0256
Mailing Address - Country:US
Mailing Address - Phone:785-823-0633
Mailing Address - Fax:785-823-0658
Practice Address - Street 1:1401 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2570
Practice Address - Country:US
Practice Address - Phone:620-342-1117
Practice Address - Fax:855-774-5285
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090014632085R0203X
KS04-229932085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0422993OtherKS LICENSE
KS100143020HMedicaid
KS100143020AMedicaid
KS100143020AMedicaid
KSKA3434001Medicare PIN
MO146240011Medicare PIN
KS100143020HMedicaid
KS100143020AMedicaid