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General NPI Number Information
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NPI Number | 1609119338
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Entity Type | Individual
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Provider Name | TRAVIS JOHN DEKKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 175 S UNION BLVD STE 125
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-3117
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Country | US
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Telephone | 719-365-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 635 E KINGS DEER PT
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City | MONUMENT
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State | CO
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Zip | 80132-8773
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Country | US
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Telephone | 505-228-6795
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Fax | 904-450-6401
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0059812
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | DR.0059812
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME141951
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License Number State | FL
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