Individual
TYSON KELLY TRAVIS
Active
Individual
TYSON KELLY TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2019035084
MO
207X00000X
Orthopaedic Surgery Physician
DO192433
OR
207X00000X
Orthopaedic Surgery Physician
SL1000
NV
Other
Enumeration date
04/29/2014
Last updated
10/22/2024
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