Healthcare Provider Details

I. General information

NPI: 1467452821
Provider Name (Legal Business Name): RICHARD P SLOAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W COLUMBIA ST SUITE 440
EVANSVILLE IN
47710-1782
US

IV. Provider business mailing address

1312 PROFESSIONAL BLVD SUITE 200
EVANSVILLE IN
47714-8007
US

V. Phone/Fax

Practice location:
  • Phone: 812-602-5442
  • Fax: 812-424-1254
Mailing address:
  • Phone: 812-491-6419
  • Fax: 812-491-6465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number1042836
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: