Individual
TRAVIS ALLEN SHUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 E CHESTNUT ST UNIT 170, LOUISVILLE, KY 40202-5701
(502) 583-3687
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
TP109
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100555610
—
KY
Enumeration date
03/21/2017
Last updated
09/22/2022
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