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Travis Bruce Banta, MD
Diagnostic Radiology Physician in Baton Rouge, Louisiana
NPI 1265964548

Travis Bruce Banta is a Diagnostic Radiology Physician based in Baton Rouge, LA and is specialized in Diagnostic Radiology. Travis Bruce Banta practices in Baton Rouge, LA and has the professional credentials of MD. The NPI Number for Travis Bruce Banta is 1265964548 and holds a License No. 91576 (Louisiana).

The current practice location address for Travis Bruce Banta is 5000 Hennessy Blvd, Baton Rouge, LA and can be reached out via phone at 225-757-0552 and via fax at 225-763-9997.

Location: 5000 Hennessy Blvd, Baton Rouge, LA, 70809-3465
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265964548
Provider Name
Travis Bruce Banta
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
5000 Hennessy Blvd, Baton Rouge, LA, 70809-3465
Phone Number
225-757-0552
Fax Number
225-763-9997
Provider Enumeration Date
03/28/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5000 Hennessy Blvd
City
Baton Rouge
State
Louisiana
Zip
70808
Phone Number
225-757-0552
Fax Number
225-763-9997
person
Provider Business Mailing Address Details
Address
5000 Hennessy Blvd
City
Baton Rouge
State
Louisiana
Zip
70808
Phone Number
225-757-0552
Fax Number
225-763-9997
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
T-3287 (Mississippi)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
91576 (Georgia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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