Judy Cooke Travis, Md, Pc | |
123 E Capitol St Demopolis AL 36732-2218 | |
(334) 289-9408 | |
Not Available |
Full Name | Judy Cooke Travis, Md, Pc |
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Speciality | Family Medicine |
Location | 123 E Capitol St, Demopolis, Alabama |
Authorized Official Name and Position | Judy C Travis (PRESIDENT) |
Authorized Official Contact | 3342899408 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Judy Cooke Travis, Md, Pc 123 E Capitol St Demopolis AL 36732-2218 Ph: (334) 289-9408 | Judy Cooke Travis, Md, Pc 123 E Capitol St Demopolis AL 36732-2218 Ph: (334) 289-9408 |
NPI Number | 1902095565 |
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Provider Enumeration Date | 10/19/2007 |
Last Update Date | 10/19/2007 |
Medicare PECOS PAC ID | 4082682166 |
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Medicare Enrollment ID | O20040917000551 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902095565 | NPI | - | NPPES |
51082149 | Other | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 11061 (Alabama) | Primary |
Provider Name | Judy Cooke Travis |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1518051788 PECOS PAC ID: 3173694494 Enrollment ID: I20111123000112 |
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