Provider Demographics
NPI:1164494795
Name:SLADE, CLIFTON STEVER (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:STEVER
Last Name:SLADE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:68 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4469
Mailing Address - Country:US
Mailing Address - Phone:719-526-7450
Mailing Address - Fax:719-526-7853
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-7450
Practice Address - Fax:719-526-7853
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA59191207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODAD000Medicare UPIN