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General NPI Number Information
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NPI Number | 1821625211
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Entity Type | Individual
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Provider Name | TRAVIS KEATON BRYAN DO
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Gender | Male
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 590 MANNING DR
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City | CHAPEL HILL
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State | NC
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Zip | 27599-4220
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Country | US
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Telephone | 215-262-2770
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Fax |
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Provider Business Mailing Address
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Address Line | 492 ANNA LYNN LN
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City | HORSHAM
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State | PA
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Zip | 19044-1509
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Country | US
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Telephone | 215-262-2770
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Fax |
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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 | 2022-03357
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License Number State | NC
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