Provider Demographics
NPI:1154322295
Name:TRAVIS, STACY D (MD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:D
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 WHITE ASH DR E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5003
Mailing Address - Country:US
Mailing Address - Phone:828-775-5872
Mailing Address - Fax:828-277-7720
Practice Address - Street 1:24 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2493
Practice Address - Country:US
Practice Address - Phone:828-277-7727
Practice Address - Fax:828-277-7720
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500467207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0770588OtherUNITED HEALTH CARE
NC898369MMedicaid
NC8369MOtherNC BLUE CROSS
NC8369MOtherNC BLUE CROSS
NC898369MMedicaid
NC0770588OtherUNITED HEALTH CARE