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NPI Code Detail

MEDICARE: DR. TRAVIS W TREADWAY M.D.

MEDICARE: DR. TRAVIS W TREADWAY 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
1207Q00000XFamily Medicine PhysicianMD423840PA

General Provider Information

NPI Number : 1326091471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRAVIS W TREADWAY M.D.
Provider Business Mailing Address
First Line : 1358 LUTZTOWN RD
Second Line :
City : BOILING SPRINGS
State : PA
Zip : 17007-9302
Country : US
Telephone Number : 717-249-8300
Fax Number : 717-249-8301
Provider Business Practice Location Address
First Line : 1358 LUTZTOWN RD
Second Line :
City : BOILING SPRINGS
State : PA
Zip : 17007-9302
Country : US
Telephone Number : 717-249-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 01/26/2023

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