Dr. Randolph Thomas Travis
DMD | Pediatric Dentist
1400 Pride Avenue, Madisonville
Kentucky, 42431-9108
270-821-7386 270-821-7401
Maps & DirectionsDr. Randolph Thomas Travis is a Madisonville, Kentucky based Pediatric Dentist who is specialized in
Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Randolph Thomas Travis is
KY. 5141 for Pediatric Dentistry in Kentucky. His current practice location is
1400 Pride Avenue, Madisonville. Patients can reach him at
270-821-7386.
Dr. Randolph Thomas Travis provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Profile:
Dr. Randolph Thomas Travis speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Randolph Thomas Travis |
| Specialization: | Pediatric Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1400 Pride Avenue, Madisonville,
Kentucky, 42431-9108 |
| Phone: | 270-821-7386 |
| Fax: | 270-821-7401 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1407862626 |
| NPI Enumeration Date: | 31 Jul, 2006 |
| NPI Last Update On: | 12 Jun, 2008 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Randolph Thomas Travis are as mentioned below.
| License Number | Specialization | State | Status | |
| KY. 5141 | Pediatric Dentistry | Kentucky | Primary | |
| INDIANA 12010320A | Pediatric Dentistry | Kentucky | Secondary | |
| OHIO 30.019661 | Pediatric Dentistry | Ohio | Secondary | |
| 5141 | General Practice Dentistry | Kentucky | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Randolph Thomas Travis such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 600-51414 | Medicaid | Kentucky | |
| 45608965 | Other | Kentucky | EPSDT |
| 200265680 A | Medicaid | Indiana | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1400 Pride Avenue,
Madisonville, Kentucky |
| Zip: | 42431-9108 |
| Phone Number: | 270-821-7386 |
| Fax Number: | 270-821-7401 |
Patients can reach Dr. Randolph Thomas Travis at
1400 Pride Avenue, Madisonville, Kentucky or can
call to book an appointment on 270-821-7386.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.