Healthcare Provider Details

I. General information

NPI: 1275586570
Provider Name (Legal Business Name): JAMES W SLEZAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

IV. Provider business mailing address

1105 WEST CHESTNUT STREET
ROGERS AR
72756-3529
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3528
  • Fax: 501-257-2513
Mailing address:
  • Phone: 479-878-2550
  • Fax: 479-878-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC-5841
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: