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NPI 1427054931

NPI 1427054931 : JOSEPH P SLIMACK MD : SAINT LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1427054931
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH P SLIMACK MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/21/2005
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    Last Update Date     |    05/13/2008
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Provider Practice Location Address
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    Address Line         |    3015 N BALLAS RD 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63131-2329
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    Country              |    US
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    Telephone            |    314-996-5330
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    Fax                  |    314-810-1399
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Provider Business Mailing Address
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    Address Line         |    14705 WHITE LANE CT 
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    City                 |    CHESTERFIELD
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    State                |    MO
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    Zip                  |    63017-7955
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    R6P69
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    License Number State |    MO
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