Healthcare Provider Details

I. General information

NPI: 1134214844
Provider Name (Legal Business Name): TRAVIS L. MATTSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE MCFARLAND CLINIC PC
AMES IA
50010-5745
US

IV. Provider business mailing address

PO BOX 3014 MCFARLAND CLINIC PC 1215 DUFF AVE
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-2155
  • Fax: 515-239-2050
Mailing address:
  • Phone: 515-239-4400
  • Fax: 515-239-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37265
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: