Provider Demographics
NPI:1669727665
Name:NEWBY, TRAVIS AARON (DO)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:AARON
Last Name:NEWBY
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-1803
Mailing Address - Country:US
Mailing Address - Phone:208-245-5551
Mailing Address - Fax:208-245-5246
Practice Address - Street 1:229 S 7TH ST
Practice Address - Street 2:
Practice Address - City:SAINT MARIES
Practice Address - State:ID
Practice Address - Zip Code:83861-1803
Practice Address - Country:US
Practice Address - Phone:208-245-5551
Practice Address - Fax:208-245-5246
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-0869207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program