Individual
DR. TRAVIS JOHN PTACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIRCLE, NAVAL MEDICAL CENTER PORTSMOUTH, PORTSMOUTH, VA 23708-2197
(757) 953-5257
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12126
SD
Other
Enumeration date
04/09/2012
Last updated
03/20/2023
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