Provider Demographics
NPI:1982691804
Name:TAMAYO, FRANCISCO X (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:X
Last Name:TAMAYO
Suffix:
Gender:M
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 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-543-6979
Mailing Address - Fax:314-364-6321
Practice Address - Street 1:7301 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4100
Practice Address - Country:US
Practice Address - Phone:479-314-6030
Practice Address - Fax:479-314-4630
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4119207RP1001X
IN01062213207RP1001X
KY45057207RP1001X
TXU4647207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154226001Medicaid
KY7100300590Medicaid
OK200029330AMedicaid
OK200029330AMedicaid
AR5M904Medicare PIN