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General NPI Number Information
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NPI Number | 1225065048
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Entity Type | Individual
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Provider Name | WHITNEY THOMPSON SLADE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 4901 RALEIGH COMMONS DRIVE SUITE 200
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City | MEMPHIS
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State | TN
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Zip | 38128
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Country | US
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Telephone | 901-387-0193
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Fax | 901-384-1645
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Provider Business Mailing Address
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Address Line | PO BOX 1000 DEPARTMENT 978
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City | MEMPHIS
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State | TN
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Zip | 38148
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Country | US
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Telephone | 901-756-5565
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Fax | 901-756-5564
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD0000020005
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD020005
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License Number State | TN
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