| Doctor Name: | DR. TRAVIS GRANGER DEATON |
| NPI Number: | 1790881308 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | AFE89486 |
| Business Practice Address: | Psc 556 Box 536 Apo, AP - 96386 |
| Business Phone Number: | 6196644318 |
| Business Fax Number: | |
| Mailing Address: | Psc 556 Box 536, APO |
| State: | AP |
| Postal Code: | 96386 |
| Phone Number: | 6196644318 |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | AFE89486 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |