Organization
TRAVIS J PTACEK MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS PTACEK M.D. (PHYSICIAN)
(605) 223-0011
Entity
Organization
Contact information
Practice address
529 KANSAS CITY ST STE 203, RAPID CITY, SD 57701-3693
(605) 223-0011
Mailing address
529 KANSAS CITY ST STE 203, RAPID CITY, SD 57701-3693
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/31/2023
Last updated
10/16/2024
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