Individual
DR. TRAVIS SCOTT MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
DEPARTMENT OF PSYCHIATRY, 30 N. 1900 E., SLC, UT 84132-0001
(801) 581-7951
(801) 581-5604
Mailing address
30 N 1900 E, SLC, UT 84132-0002
(801) 581-7951
(801) 581-5604
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
6837701-1205
UT
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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