Individual
TRAVIS BOAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3053 W STATE ST, BRISTOL, TN 37620-1720
(423) 301-6567
(423) 573-9672
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720
(423) 301-6567
(423) 573-9672
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
200201050
NC
2085R0202X
Diagnostic Radiology Physician
28433
SC
2085R0202X
Diagnostic Radiology Physician
36750
TN
Other
Enumeration date
07/05/2006
Last updated
07/11/2023
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