Individual
DR. TRAVIS WAYNE MCCLINTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1535 GULL RD, MSB 015, KALAMAZOO, MI 49048-1650
(269) 226-6933
(269) 226-6949
Mailing address
1535 GULL RD, MSB 015, KALAMAZOO, MI 49048-1650
(269) 226-6933
(269) 226-6949
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301084373
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G56008
MEDICARE GROUP-TR HEALTH
MI
05
—
105190445
—
MI
01
—
700G560080
BCBS GROUP-THREE RIVERS HEALTH
MI
01
—
TM084373
BLUE CROSS BLUE SHIELD
MI
Enumeration date
04/24/2007
Last updated
03/10/2009
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