Travis Arron Dugan, DO
Individual provider Active NPI Internal Medicine Physician · Fort Knox, KY
NPI 1346376175 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1346376175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 3308 (AZ)
- Practice address
- 289 Ireland Ave
Fort Knox, KY 40121-5111 - Phone
- (502) 624-9192
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121218000574 | KY | Order and Referring Only - Family Practice |
8224280391 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3308 | AZ | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3308 | AZ | Yes |
Addresses
Primary practice location
289 Ireland Ave
Fort Knox, KY 40121-5111
Mailing address
289 Ireland Ave
Fort Knox, KY 40121-5111
Phone (502) 624-9192
Other providers in Fort Knox, KY
- Rita M Devore
- Renee L Dodge
- Momodoulamin S Drammeh
- Douglas M Dudewicz
- Lauri Lyn Duesler
- Ronald R Duke
- Judy D Dulin
- Rhonda L Earls
- Marie G Edling
- Robert Conrad Egbert Jr.
All providers in Fort Knox, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.