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Organization

TRAVIS PAUL MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GROVER TRAVIS PAUL MD FACS (PHYSICIAN OWNER)
(251) 580-4243
Entity
Organization

Contact information

Practice address
2002 HAND AVE, BAY MINETTE, AL 36507
(251) 580-1760
(251) 580-4189
Mailing address
PO BOX 1405, BAY MINETTE, AL 36507-1405
(251) 580-4243
(251) 580-4189

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51003894
BCBS OF AL BAY MINETTE LOCATION
AL
01
51106179
BCBS OF AL ATMORE LOCATION
AL
Enumeration date
07/10/2006
Last updated
11/08/2010
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