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Individual

DR. JOEL TRAVIS TANAKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
ROBINSON FAMILY MEDICINE CLINIC (TMC10), FORT CARSON, CO 80913-4604
(719) 524-2207
(719) 524-2258
Mailing address
EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC, 1650 COCHRANE CIRCLE ATTN: CREDENTIALS OFFICE, FORT CARSON, CO 80913-4604
(719) 526-7844
(719) 526-7984

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9800712
NC

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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