Slade, Travis D

Slade, Travis D is an individual health care provider with primary practice located at 5475 S 500 E , Ogden UT 84405-6905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Slade, Travis D can be contacted via phone (800) 880-3566.

Contact Information

Primary practice address
5475 S 500 E Ogden UT 84405-6905
Phone: (800) 880-3566
Fax: (801) 733-5872
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 5968724-1205 Utah

Profile Details

NPI number 1366453193
LBN Legal business name Slade, Travis D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1366453193 NPPES
Utah Other 68295 PEHP
Utah Other 908627 PEHP
Utah Other 107040787101 PEHP
Utah Other 346248 PEHP
Utah Other 6757 PEHP
Utah Other QMP000003333370 PEHP

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