Individual
DR. TRAVIS WAYNE ANSCHUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 MEDICAL CENTER PKWY, BENTONVILLE, AR 72712-3217
(479) 553-1294
Mailing address
3100 CHANNING WAY # 100, IDAHO FALLS, ID 83404-7533
(208) 535-4575
(208) 535-4569
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
39175
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
E-11227
AR
2080N0001X
Neonatal-Perinatal Medicine Physician
M10102
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808012100
—
ID
Enumeration date
02/02/2007
Last updated
09/08/2020
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