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General NPI Number Information
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NPI Number | 1770580169
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Entity Type | Individual
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Provider Name | CHRISTIAAN JOHANNES SLABBERT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 7320 ROGERS AVE SUITE 1
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City | FORT SMITH
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State | AR
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Zip | 72903-4164
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Country | US
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Telephone | 479-452-6362
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Fax | 479-484-5652
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Provider Business Mailing Address
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Address Line | 8600 S 36TH TER STE A
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City | FORT SMITH
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State | AR
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Zip | 72908-8768
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Country | US
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Telephone | 479-709-7465
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Fax | 479-709-7466
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E2531
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License Number State | AR
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