Robert Gordon Travnicek, MD MPH

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

12447 Issued in MS

Practice address

15151 Community Rd
Gulfport, MS 39503-3525

Phone

(228) 831-5151

Fax

(228) 831-5383

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1447330030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15151 COMMUNITY RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033525",
            "telephone_number": "228-831-5151",
            "fax_number": "228-831-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15151 COMMUNITY RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033525",
            "telephone_number": "228-831-5151",
            "fax_number": "228-831-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVNICEK",
        "first_name": "ROBERT",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MS",
            "license": "12447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123687",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Public Health & General Preventive Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Public Health & General Preventive Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.