Provider Demographics
NPI:1871792168
Name:ABELE, TRAVIS AUSTIN (MD)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:AUSTIN
Last Name:ABELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 NE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6061
Mailing Address - Country:US
Mailing Address - Phone:541-382-6633
Mailing Address - Fax:541-382-2719
Practice Address - Street 1:1460 NE MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6061
Practice Address - Country:US
Practice Address - Phone:541-382-6633
Practice Address - Fax:541-382-2719
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1663162085R0202X
TXN15122085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0029783OtherINSTITUTIONAL PERMIT