Riddell, Travis John

Riddell, Travis John is an individual health care provider with primary practice located at 557 E. Broadway , Jackson WY 83001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Riddell, Travis John can be contacted via phone (307) 733-4627.

Contact Information

Primary practice address
557 E. Broadway Jackson WY 83001
Phone: (307) 733-4627
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 229430 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 8169A Wyoming
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-10596 Idaho

Profile Details

NPI number 1720255128
LBN Legal business name Riddell, Travis John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2008
Last updated Jul 2nd, 2009 - about 17 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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