Provider Demographics
NPI:1265867493
Name:JAMES W. SLEZAK, JR., M.D., P.A.
Entity Type:Organization
Organization Name:JAMES W. SLEZAK, JR., M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:SLEZAK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:479-466-0432
Mailing Address - Street 1:116 WOODCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-3691
Mailing Address - Country:US
Mailing Address - Phone:479-466-0432
Mailing Address - Fax:479-756-8847
Practice Address - Street 1:116 WOODCLIFF RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-3691
Practice Address - Country:US
Practice Address - Phone:479-466-0432
Practice Address - Fax:479-756-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC2281208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty