Healthcare Provider Details

I. General information

NPI: 1508276742
Provider Name (Legal Business Name): JOSHUA RYAN SLOAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 AVENUE B
SCOTTSBLUFF NE
69361-4602
US

IV. Provider business mailing address

4021 AVENUE B
SCOTTSBLUFF NE
69361-4602
US

V. Phone/Fax

Practice location:
  • Phone: 308-635-3711
  • Fax:
Mailing address:
  • Phone: 308-630-1111
  • Fax: 308-630-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number29898
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: