Individual
TRAVIS COLIN GULLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 E MARKET ST, WARREN, OH 44483-6608
(330) 841-9221
Mailing address
2354 KEYSTONE TRL N, CORTLAND, OH 44410-2713
(503) 381-1659
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
093953
OH
207P00000X
Emergency Medicine Physician
42891
TN
207P00000X
Emergency Medicine Physician
MD27310
OR
Other
Enumeration date
11/20/2006
Last updated
09/28/2010
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