Individual
DR. JOE TIMOTHY TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 466-2076
Mailing address
1206 RIVERSIDE DR, MONROE, LA 71201-5215
(318) 557-2806
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
019966
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1935824
—
LA
01
—
343661YMSL
MEDICARE
LA
Enumeration date
07/07/2006
Last updated
07/24/2024
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