Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 23614 | AZ |
Y | 207XS0117X | Orthopaedic Spine Surgeon | D125395 | NM |
N | 207XS0117X | Orthopaedic Spine Surgeon | MD2007-0211 | NM |
NPI | 1194773911 |
---|---|
Provider Name | Dr. Douglas A Slaughter |
First Address | Albuquerque, NM 87120-4297 |
Second Address | Albuquerque, NM 87120-4297 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 09/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10034053 | LOVELACE (01) | |
2029647 | UHC (01) | |
74132067 | (05) | NM |
D125395 | (02) | |
D125395 | (02) | AZ |
NM002Q02 | BCBS NM (01) | NM |
QMP000003391181 | MOLINA (01) |