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General NPI Number Information
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NPI Number | 1972572535
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Entity Type | Individual
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Provider Name | TRAVIS R. ALLEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1616 N LITCHFIELD RD STE A230
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City | GOODYEAR
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State | AZ
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Zip | 85395-1252
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Country | US
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Telephone | 623-469-4688
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Fax | 623-284-0959
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Provider Business Mailing Address
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Address Line | 5115 N DYSART RD STE 202-172
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-3032
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Country | US
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Telephone |
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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 | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 62891
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 62891
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 62891
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License Number State | AZ
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