MEDICARE: DR. JAMES FRANK SLAUGHENHAUPT II DO

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	34.006693	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00461890	OTHER	OH	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0000000518586	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1821093774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES FRANK SLAUGHENHAUPT II DO

Provider Business Mailing Address
First Line	:	10 REMICK BLVD
Second Line	:
City	:	SPRINGBORO
State	:	OH
Zip	:	45066-9168
Country	:	US
Telephone Number	:	937-531-0124
Fax Number	:	937-531-0129

Provider Business Practice Location Address
First Line	:	10 REMICK BLVD
Second Line	:
City	:	SPRINGBORO
State	:	OH
Zip	:	45066-9168
Country	:	US
Telephone Number	:	937-531-0124
Fax Number	:	937-531-0129

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	11/20/2020

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Directions to “ DR. JAMES FRANK SLAUGHENHAUPT II DO” Practice Location

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