Provider Demographics
NPI:1508284902
Name:SMITH, TRAVIS M (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7301 PEAK DR
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:702-240-1215
Mailing Address - Fax:702-243-7531
Practice Address - Street 1:2950 S. MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-732-6000
Practice Address - Fax:702-732-6071
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2021-06-10
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Provider Licenses
StateLicense IDTaxonomies
CAA1594192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty