Individual
TRAVIS R JAMESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W HAY ST, DECATUR, IL 62526-4162
(217) 876-6860
(217) 876-6868
Mailing address
301 W HAY ST, DECATUR, IL 62526-4162
(217) 876-6860
(217) 876-6868
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036133033
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336094236
CS LICENSE
IL
Enumeration date
06/25/2010
Last updated
01/30/2025
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