Provider Demographics
NPI:1841241031
Name:SLOCUM, JAMES L (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:SLOCUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1775 ARLINGTON ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2104
Mailing Address - Country:US
Mailing Address - Phone:941-955-6773
Mailing Address - Fax:941-365-8627
Practice Address - Street 1:1775 ARLINGTON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2104
Practice Address - Country:US
Practice Address - Phone:941-955-6773
Practice Address - Fax:941-365-8627
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00241462084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71767Medicare ID - Type Unspecified