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NPI Code Detail

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

MEDICARE: RANDALL J SLICKERS, 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
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080105158OTHERIDRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790723690
Entity Type Code : Organization
Provider Name (Legal Business Name) : RANDALL J SLICKERS, M.D., P.C.
Provider Business Mailing Address
First Line : 1235 FILER AVE E
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-4118
Country : US
Telephone Number : 208-734-3226
Fax Number : 208-734-3675
Provider Business Practice Location Address
First Line : 1235 FILER AVE E
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-4118
Country : US
Telephone Number : 208-734-3226
Fax Number : 208-734-3675
Authorized Official
Title or Position : PHYSICIAN
Name : RANDALL J SLICKERS
Credential : M.D.
Telephone Number : 208-734-3226
Provider Enumeration Date : 06/03/2006
Last Update Date : 06/17/2008

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