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NPI Code Detail

MEDICARE: DR. TRAVIS ROGER WILEMON DC BS

MEDICARE: DR. TRAVIS ROGER WILEMON DC BS
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
1111N00000XChiropractorCH7877FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188299OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962400499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRAVIS ROGER WILEMON DC BS
Provider Business Mailing Address
First Line : 801 NE 25TH AVE
Second Line :
City : OCALA
State : FL
Zip : 34470-6319
Country : US
Telephone Number : 352-732-0200
Fax Number : 352-732-2623
Provider Business Practice Location Address
First Line : 801 NE 25TH AVE
Second Line :
City : OCALA
State : FL
Zip : 34470-6319
Country : US
Telephone Number : 352-732-0200
Fax Number : 352-732-2623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 07/08/2007

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Directions to “ DR. TRAVIS ROGER WILEMON DC BS” Practice Location

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