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NPI Code Detail

MEDICARE: DR. TRAVIS JOSEPH POWELL M.D.

MEDICARE: DR. TRAVIS JOSEPH POWELL 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
1207V00000XObstetrics & Gynecology Physician53194AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R73518OTHERAZTRAINING PERMIT

General Provider Information

NPI Number : 1538423520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRAVIS JOSEPH POWELL M.D.
Provider Business Mailing Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Provider Business Practice Location Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2012
Last Update Date : 05/15/2026

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