MEDICARE: STACY N SLADE PA

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	363A00000X	Physician Assistant	5601004319	MI

General Provider Information

NPI Number	:	1265459267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY N SLADE PA

Provider Business Mailing Address
First Line	:	1225 W FRONT ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2368
Country	:	US
Telephone Number	:	231-935-0788
Fax Number	:	231-935-0787

Provider Business Practice Location Address
First Line	:	1225 W FRONT ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2368
Country	:	US
Telephone Number	:	231-935-0788
Fax Number	:	231-935-0787

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	09/01/2014

Similar Medicare Providers

1659195782 — MR. ELIAS SANCHEZ PA
Practice Location Address:

1225 W FRONT ST STE C
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-642-5031
Practice Fax: 231-525-2306

1801891973 — TETER ORTHOTICS & PROSTHETICS, INC
Practice Location Address:

1225 W FRONT ST STE A
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-947-5701
Practice Fax: 231-947-1370

1336117456 — NANCY MORRIS PAC
Practice Location Address:

1225 W FRONT ST
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-935-0788
Practice Fax: 231-935-0787

1891717039 — MEREDITH L MCDONALD PA-C
Practice Location Address:

1225 W FRONT ST
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-935-0788
Practice Fax: 231-935-0787

1801979679 — MRS. PATRICIA RENEE TKACH P.T.
Practice Location Address:

1225 W FRONT ST
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-935-0788
Practice Fax: 231-935-0787

1407906241 — DAVID JAY LYONS MPT
Practice Location Address:

1225 W FRONT ST
TRAVERSE CITY, MI
49684-2368

Practice Phone: 231-935-0788
Practice Fax: 231-935-0787

Directions to “ STACY N SLADE PA” 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 © 2007-2026 (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.