Individual
TRAVIS MASSENGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
350 HOSPITAL WAY, SOMERSET, KY 42503-2872
(606) 451-2624
(606) 451-5506
Mailing address
350 HOSPITAL WAY, SOMERSET, KY 42503-2872
(606) 451-2624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04599
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
05/09/2020
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