Provider Demographics
NPI:1629417191
Name:SLYCORD, SUSAN LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LYNN
Last Name:SLYCORD
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:701 10TH ST SE FL HPCC3
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1292
Mailing Address - Country:US
Mailing Address - Phone:319-363-8303
Mailing Address - Fax:319-364-4659
Practice Address - Street 1:701 10TH ST SE FL HPCC3
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1292
Practice Address - Country:US
Practice Address - Phone:319-363-8303
Practice Address - Fax:319-364-4659
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IADO-04757207RX0202X
IAR-9719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine