Individual
DR. TRAVIS EDWARD CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 941-4500
Mailing address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 941-4500
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01067694A
IN
207X00000X
Orthopaedic Surgery Physician
44976
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201047300
—
IN
01
—
50045559
KY PASSPORT
KY
05
—
7100132700
—
KY
01
—
768066
ANTHEM
IN
01
—
9087848
AETNA
IN
Enumeration date
05/10/2007
Last updated
07/05/2022
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