Provider Demographics
NPI:1891808101
Name:SLAYTON, ERIC (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SLAYTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 BRIDGTON RD
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1438
Mailing Address - Country:US
Mailing Address - Phone:207-935-3383
Mailing Address - Fax:207-935-3632
Practice Address - Street 1:253 BRIDGTON RD
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1438
Practice Address - Country:US
Practice Address - Phone:207-935-3383
Practice Address - Fax:207-935-3632
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME43314119Medicaid
ME000756001Medicare PIN