Bruce, Travis O
Bruce, Travis O is an individual health care provider with primary practice located at 2817 Rock Merritt Ave Bldg 4-3219 , Fort Liberty NC 28310-4613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Bruce, Travis O can be contacted via phone (105) 703-0489.Contact Information
Primary practice address
2817 Rock Merritt Ave Bldg 4-3219
Fort Liberty NC 28310-4613
Phone: (105) 703-0489
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 23877 | South Carolina |
Profile Details
| NPI number | 1831150440 |
|---|---|
| LBN Legal business name | Bruce, Travis O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Oct 1st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831150440 | NPPES |
| South Carolina | MEDICAID | 238772 |
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