MEDICARE: DR. JOCELYN D SLAUGHTER M.D.

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	207V00000X	Obstetrics & Gynecology Physician	003449	GA

General Provider Information

NPI Number	:	1134384829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOCELYN D SLAUGHTER M.D.

Provider Business Mailing Address
First Line	:	2860 MAIN ST W
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3156
Country	:	US
Telephone Number	:	770-809-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 MAIN ST W STE A
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3156
Country	:	US
Telephone Number	:	770-809-1100
Fax Number	:

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	12/28/2020

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