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General NPI Number Information
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NPI Number | 1316134448
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Entity Type | Organization
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Legal Business Name | ROBERT R. SLATER, JR, MD. INCORPORATED
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1568 CREEKSIDE DRIVE SUITE 206
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City | FOLSOM
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State | CA
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Zip | 95630
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Country | US
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Telephone | 916-404-4400
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Fax | 916-790-5924
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Provider Business Mailing Address
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Address Line | 1568 CREEKSIDE DR. SUITE 206
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City | FOLSOM
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State | CA
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Zip | 95630
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Country | US
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Telephone | 916-404-4400
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Fax | 916-790-5924
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT RANDALL SLATER JR.
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Credential | M.D.
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Telephone | 916-404-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | G80954
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License Number State | CA
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