MEDICARE: CHRISTIAAN JOHANNES SLABBERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E2531	AR

General Provider Information

NPI Number	:	1770580169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAAN JOHANNES SLABBERT M.D.

Provider Business Mailing Address
First Line	:	8600 S 36TH TER
Second Line	:	STE A
City	:	FORT SMITH
State	:	AR
Zip	:	72908-8768
Country	:	US
Telephone Number	:	479-709-7465
Fax Number	:	479-709-7466

Provider Business Practice Location Address
First Line	:	7320 ROGERS AVE
Second Line	:	SUITE 1
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4164
Country	:	US
Telephone Number	:	479-452-6362
Fax Number	:	479-484-5652

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	04/01/2016

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