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NPI Code Detail

MEDICARE: DR. TRAVIS PEVETO MD

MEDICARE: DR. TRAVIS PEVETO 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
1207Q00000XFamily Medicine PhysicianDR0058804CO

General Provider Information

NPI Number : 1780038802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRAVIS PEVETO MD
Provider Business Mailing Address
First Line : 2509 RESEARCH BLVD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-8108
Country : US
Telephone Number : 970-224-1550
Fax Number :
Provider Business Practice Location Address
First Line : 2509 RESEARCH BLVD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-8108
Country : US
Telephone Number : 970-224-1550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 03/03/2025

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