Doctor Name: | MR. TRAVIS D POPE |
NPI Number: | 1104069210 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | IDMT |
License Number: | P8023941 |
Business Practice Address: | 113 Lielmanis Ave Hurlburt Field, FL - 325445613 |
Business Phone Number: | 8508813413 |
Business Fax Number: | |
Mailing Address: | 113 Lielmanis Ave, HURLBURT FIELD |
State: | FL |
Postal Code: | 325445613 |
Phone Number: | 8508813413 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2009 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 146L00000X |
License Number: | P8023941 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Emergency Medical Service Providers |
Taxonomy Classification: | Emergency Medical Technician, Paramedic |
Taxonomy Specialization: | |
Taxonomy Definition: | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |