Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 12192R | LA |
Y | 208200000X | Surgeon | 036144935 | IL |
Y | 208600000X | Surgeon | 036144935 | IL |
NPI | 1134213481 |
---|---|
Provider Name | Dr. Douglas Slakey |
First Address | New Orleans, LA 70112-2632 |
Second Address | New Orleans, LA 70112-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 15/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1698555 | (05) | LA |
G07200 | (02) | LA |