Tamiko Clayton
Individual provider Active NPI Non-emergency Medical Transport (VAN) · Brusly, LA
NPI 1962869263 · NPPES record last updated Jan 19, 2016
Key facts
- NPI
- 1962869263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Non-emergency Medical Transport (VAN) 343900000X
- License
- 005474901 (LA)
- Practice address
- 4042 Choctaw Rd
Brusly, LA 70719-2303 - Phone
- (225) 202-5276
- NPI assigned
- Jan 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005474901 | LA | MD | Non-emergency Medical Transport (VAN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | 005474901 | LA | Yes |
Addresses
Primary practice location
4042 Choctaw Rd
Brusly, LA 70719-2303
Mailing address
4042 Choctaw Rd
Brusly, LA 70719-2303
Phone (225) 202-5276
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2190466 | Medicaid | LA |
Other providers in Brusly, LA
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- Melody Bynum
- Sheralyn King Callihan-Favrot
- Ledidra Carter-Bell
- Convenient Care LLC
- Allison P Cutrer
- Daniel Pharmacy LLC
- Alicia David
- Donald H. De Latin
All providers in Brusly, LA · Non-emergency Medical Transport (VAN) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.