Blalock, Travis Wayne

Blalock, Travis Wayne is an individual health care provider with primary practice located at 619 Ne 13Th St , Oklahoma City OK 73104-5001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Blalock, Travis Wayne can be contacted via phone (405) 271-6110.

Contact Information

Primary practice address
619 Ne 13Th St Oklahoma City OK 73104-5001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 73100 Georgia
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X A116875 California

Profile Details

NPI number 1710195003
LBN Legal business name Blalock, Travis Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Feb 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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