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NPI Code Detail

MEDICARE: RANDALL J. SLOVIS, M.D. P.C.

MEDICARE: RANDALL J. SLOVIS, M.D. P.C.
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
1207R00000XInternal Medicine Physician025392GA

General Provider Information

NPI Number : 1760592513
Entity Type Code : Organization
Provider Name (Legal Business Name) : RANDALL J. SLOVIS, M.D. P.C.
Provider Business Mailing Address
First Line : 45 ASHEWORTH CT NW
Second Line :
City : ATLANTA
State : GA
Zip : 30327-1532
Country : US
Telephone Number : 770-458-1594
Fax Number : 770-458-1596
Provider Business Practice Location Address
First Line : 2151 PEACHFORD RD
Second Line :
City : ATLANTA
State : GA
Zip : 30338-6534
Country : US
Telephone Number : 770-445-3200
Fax Number : 770-458-1594
Authorized Official
Title or Position : OWNER
Name : DR. RANDALL JAY SLOVIS
Credential : M.D.
Telephone Number : 770-458-1594
Provider Enumeration Date : 08/30/2006
Last Update Date : 08/22/2020

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