Individual
TRAVIS SCOTT WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 585-3229
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3105478-1205
UT
207RC0000X
Cardiovascular Disease Physician
3105478-1205
UT
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
3105478-1205
UT
Other
Enumeration date
10/18/2006
Last updated
08/08/2023
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