Individual
TRAVIS KANALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 RENAISSANCE BLVD STE 120, EDMOND, OK 73013
(405) 844-8572
(405) 844-9143
Mailing address
1701 RENAISSANCE BLVD STE 110, EDMOND, OK 73013-3084
(405) 844-4978
(405) 844-0562
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
24574
OK
Other
Enumeration date
05/07/2007
Last updated
11/04/2019
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