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NPI Code Detail

MEDICARE: WILLIAM JOSEPH TRAVIS M.D.

MEDICARE: WILLIAM JOSEPH TRAVIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician24510KY
2207R00000XInternal Medicine Physician01078803AIN
3207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician01078803AIN
4207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician24510KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174513790
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM JOSEPH TRAVIS M.D.
Provider Business Mailing Address
First Line : 6200 DUTCHMANS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-3271
Country : US
Telephone Number : 502-456-6200
Fax Number : 502-456-6655
Provider Business Practice Location Address
First Line : 6200 DUTCHMANS LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-3271
Country : US
Telephone Number : 502-456-6200
Fax Number : 502-456-6655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 02/19/2024

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