Provider Demographics
NPI:1174512669
Name:ENGAR, TRAVIS C (DO)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:C
Last Name:ENGAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 W HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4641
Mailing Address - Country:US
Mailing Address - Phone:435-630-0145
Mailing Address - Fax:435-636-4896
Practice Address - Street 1:300 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4218
Practice Address - Country:US
Practice Address - Phone:435-637-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5202581-1204207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD4739Medicaid
UTH72008Medicare UPIN
UTD4739Medicaid