Provider Demographics
NPI:1336116185
Name:SLAYMAKER, LANCE BARTON (D O)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:BARTON
Last Name:SLAYMAKER
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 MISSION RD
Mailing Address - Street 2:#350
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3006
Mailing Address - Country:US
Mailing Address - Phone:913-642-2100
Mailing Address - Fax:913-642-2127
Practice Address - Street 1:7301 MISSION RD
Practice Address - Street 2:#350
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3006
Practice Address - Country:US
Practice Address - Phone:913-642-2100
Practice Address - Fax:913-642-2127
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0528735208000000X
MO112944208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H24803Medicare UPIN