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Individual

DR. TRAVIS W MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 945-6535
(970) 945-5429
Mailing address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-7300
(970) 945-4529

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
19575
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01195759
CO
01
CO19575
COLORADO LICENSE
CO
01
VAH2004
BCBS PROVIDER
CO
Enumeration date
11/03/2006
Last updated
01/03/2014
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