1336116185 NPI number — DR. LANCE BARTON SLAYMAKER D O

Table of content: DR. LANCE BARTON SLAYMAKER D O (NPI 1336116185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336116185 NPI number — DR. LANCE BARTON SLAYMAKER D O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLAYMAKER
Provider First Name:
LANCE
Provider Middle Name:
BARTON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D O
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336116185
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7301 MISSION RD
Provider Second Line Business Mailing Address:
#350
Provider Business Mailing Address City Name:
PRAIRIE VILLAGE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66208-3006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-642-2100
Provider Business Mailing Address Fax Number:
913-642-2127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7301 MISSION RD
Provider Second Line Business Practice Location Address:
#350
Provider Business Practice Location Address City Name:
PRAIRIE VILLAGE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66208-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-642-2100
Provider Business Practice Location Address Fax Number:
913-642-2127
Provider Enumeration Date:
03/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0528735 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 112944 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com