Provider Demographics
NPI:1851476030
Name:SLOAN, JOHN L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:SLOAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:115 BEATTIE PARK RD
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-1410
Mailing Address - Country:US
Mailing Address - Phone:864-845-3331
Mailing Address - Fax:864-845-3152
Practice Address - Street 1:115 BEATTIE PARK RD
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-1410
Practice Address - Country:US
Practice Address - Phone:864-845-3331
Practice Address - Fax:864-845-3051
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC14031207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC140314Medicaid
E40943Medicare UPIN
SC140314Medicaid