Healthcare Provider Details
I. General information
NPI: 1801195276
Provider Name (Legal Business Name): JONATHAN DENNIS SLOTHOWER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/24/2011
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1780 BROWNING WAY
ELKO NV
89801-8357
US
IV. Provider business mailing address
1780 BROWNING WAY
ELKO NV
89801-8357
US
V. Phone/Fax
- Phone: 775-778-3437
- Fax: 775-778-3652
- Phone: 775-778-3652
- Fax: 775-778-3652
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 269013 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | DO1906 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: