Provider Demographics
NPI:1619972585
Name:SLATKIN, ALEXANDRE LEONI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRE
Middle Name:LEONI
Last Name:SLATKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 4TH ST
Mailing Address - Street 2:STE 5A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-448-1249
Mailing Address - Fax:318-448-9644
Practice Address - Street 1:201 4TH ST
Practice Address - Street 2:STE 5A
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-448-1249
Practice Address - Fax:318-448-9644
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04113R207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1188964Medicaid
LA5K525Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
LA1188964Medicaid