Individual
DR. LARRY L TAGTMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2504 W 15TH AVE, EMPORIA, KS 66801-6102
(620) 342-7054
(620) 342-8203
Mailing address
2504 W 15TH AVE, EMPORIA, KS 66801-6102
(620) 342-7054
(620) 342-8203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1042-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0279700001
CIGNA DMERC
—
05
—
100091020B
—
KS
01
—
410014645
RAILROAD MEDICARE
—
Enumeration date
08/12/2005
Last updated
08/11/2008
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