Provider Demographics
NPI:1104194760
Name:J GEOFFREY SLINGSBY MD, PC
Entity Type:Organization
Organization Name:J GEOFFREY SLINGSBY MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J. GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLINGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-719-9499
Mailing Address - Street 1:240 MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6200
Mailing Address - Country:US
Mailing Address - Phone:605-719-9499
Mailing Address - Fax:605-719-9509
Practice Address - Street 1:1640 HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-6987
Practice Address - Country:US
Practice Address - Phone:605-719-9499
Practice Address - Fax:605-719-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD16310207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE46046232500Medicaid
SD4997289OtherWELLMARK BLUE CROSS BLUE SHIELD
SDS8482Medicare PIN
SD4997289OtherWELLMARK BLUE CROSS BLUE SHIELD