Healthcare Provider Details

I. General information

NPI: 1457391021
Provider Name (Legal Business Name): SCOTT L SLIVKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 HENRY ST
NORTH VERNON IN
47265-1030
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 812-352-4300
  • Fax: 812-352-4301
Mailing address:
  • Phone: 513-246-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35-072309
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01044387A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-072309
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: