Male or Other

Travis R. Von Tobel M.D.

Interventional Pain Medicine Physician in Jacksonville, FL(View on Map)

Full Name

Travis Randall Von Tobel M.D.

NPI Number

1487954723

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/02/2010

Specialties

(Taxonomies)

Code

208VP0014X
208600000X

Primary Taxonomy

Yes
No

Licenses

State

Florida
New York

License Number

ME117856
244805

Contact
Information

Purpose

Mailing
Location

Address

4100 SOUTHPOINT DR E STE 1
4100 SOUTHPOINT DR E STE 1

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32216-8710
32216-8710

Country

US
US

Telephone Number

(904) 647-5266
(904) 647-5266

Identifiers

Identifier

014945000

Identifier State

FL

Identifier Issuer

Unknown

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

shannon@optimus-labs.com

Endpoint Description

Direct email

Use

Direct

Content Type

CSV

Affiliation

N

Endpoint Location

1895 Kingsley Ave Ste 1005BOrange Park, FL320734466US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/03/2022

Provider Address

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