Dr. 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:
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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.