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General NPI Number Information
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NPI Number | 1376980367
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Entity Type | Individual
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Provider Name | TRAVIS D EWING DO
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Gender | Male
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 1111 WINDOVER RD
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City | JONESBORO
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State | AR
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Zip | 72401-6159
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Country | US
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Telephone | 870-936-8000
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Fax | 870-934-3653
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Provider Business Mailing Address
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Address Line | PO BOX 1960
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City | JONESBORO
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State | AR
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Zip | 72403-1960
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Country | US
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Telephone | 870-936-8000
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Fax | 870-934-3652
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-8862
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | E8862
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License Number State | AR
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