MEDICARE: TRAVIS N CALHOUN MD

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
1	207R00000X	Internal Medicine Physician	27306	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1770594210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS N CALHOUN MD

Provider Business Mailing Address
First Line	:	538B NOEL AVE
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-1386
Country	:	US
Telephone Number	:	270-632-4515
Fax Number	:	270-632-4516

Provider Business Practice Location Address
First Line	:	538B NOEL AVE
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-1386
Country	:	US
Telephone Number	:	270-632-4515
Fax Number	:	270-632-4516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	02/01/2017

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Directions to “ TRAVIS N CALHOUN MD” Practice Location

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