Provider Demographics
NPI:1235371493
Name:STIEGLER, TRAVIS CLARK (DO)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:CLARK
Last Name:STIEGLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1501 S YALE ST
Mailing Address - Street 2:STE 250
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7304
Mailing Address - Country:US
Mailing Address - Phone:928-556-0707
Mailing Address - Fax:928-779-2223
Practice Address - Street 1:1501 S YALE ST
Practice Address - Street 2:STE 250
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7304
Practice Address - Country:US
Practice Address - Phone:928-556-0707
Practice Address - Fax:928-779-2223
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR10492084P0800X
AZ005517208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry