Provider Demographics
NPI:1093005522
Name:SLOCUM, STEPHANIE CHARLEVILLE LEVENSON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CHARLEVILLE LEVENSON
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:CHARLEVILLE
Other - Last Name:LEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8160 WALNUT HILL LN STE 116
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4442
Mailing Address - Country:US
Mailing Address - Phone:214-365-1150
Mailing Address - Fax:
Practice Address - Street 1:1531 HUNT CLUB BLVD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6095
Practice Address - Country:US
Practice Address - Phone:615-230-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6906207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology