Provider Demographics
NPI:1275586570
Name:SLEZAK, JAMES W (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:SLEZAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1105 WEST CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3529
Mailing Address - Country:US
Mailing Address - Phone:479-878-2550
Mailing Address - Fax:479-878-2555
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-3528
Practice Address - Fax:501-257-2513
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC-5841208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR110942001Medicaid
AR54904F181Medicare ID - Type Unspecified
ARD09011Medicare UPIN