Individual
TRAVIS HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 FRANKLIN AVE STE 210, NORMAL, IL 61761-3588
(309) 268-3900
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125-046054
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036121834
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932320819
—
MO
Enumeration date
05/01/2007
Last updated
12/07/2023
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