Individual
TRAVIS FAWVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
435 2ND ST, NEWPORT, TN 37821-3703
(423) 625-2200
Mailing address
PO BOX 636019, CINCINNATI, OH 45263-6019
(865) 985-7234
(865) 985-7077
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1710
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3319552
—
TN
01
—
4113345
BCBS OF TN
TN
01
—
P00310644
RAILROAD MEDICARE
TN
Enumeration date
06/04/2006
Last updated
11/06/2007
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