Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 20908 | NH |
Y | 208600000X | Surgeon | 20908 | NH |
N | 2086S0122X | Plastic and Reconstructive Surgery | 20908 | NH |
N | 2086S0122X | Plastic and Reconstructive Surgery | 67919-20 | WI |
NPI | 1275913733 |
---|---|
Provider Name | Dr. Alexander Henry Slocum JR. |
First Address | Portsmouth, NH 03801-7102 |
Second Address | Portsmouth, NH 03801-7102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2015 |
Last Update Date | 20/07/2021 |