MEDICARE: JANTZEN T SLATER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9865992-1205	UT
2	207Q00000X	Family Medicine Physician	E-11402	AR

General Provider Information

NPI Number	:	1063891570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANTZEN T SLATER MD

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	LOWELL
State	:	AR
Zip	:	72745
Country	:	US
Telephone Number	:	479-463-7775
Fax Number	:	479-463-7187

Provider Business Practice Location Address
First Line	:	199 E. MAIN ST.
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-3077
Country	:	US
Telephone Number	:	479-267-1001
Fax Number	:	479-267-1026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2015
Last Update Date	:	07/19/2018

Similar Medicare Providers

1427058593 — COLLIER DRUG STORES INC
Practice Location Address:

197 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-4303
Practice Fax: 479-267-4311

1518925817 — DEBORAH KAY SWEATT ANP
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1952316390 — FARMINGTON FAMILY MEDICAL LLC
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1275839011 — WASHINGTON REGIONAL MEDICAL SYSTEM
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1083190318 — JULIA MARIA FUSTER PA-C
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-463-1001
Practice Fax: 479-463-1026

1871286286 — COLLIER DRUG STORES INC
Practice Location Address:

197 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-4303
Practice Fax: 479-267-4311

Directions to “ JANTZEN T SLATER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.