Jasper, Travan K

Jasper, Travan K is an individual health care provider with primary practice located at 5661 Bunky Way , Dunwoody GA 30338-3338. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jasper, Travan K can be contacted via phone (770) 652-7341.

Contact Information

Primary practice address
5661 Bunky Way Dunwoody GA 30338-3338
Phone: (770) 652-7341
Fax: (770) 396-9860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 045506 Georgia

Profile Details

NPI number 1184738528
LBN Legal business name Jasper, Travan K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Nov 2nd, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184738528 NPPES
Georgia MEDICAID 000794945E
Georgia MEDICAID 000794945F
Georgia MEDICAID 000794945C
Georgia MEDICAID 000794945D

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