Provider Demographics
NPI:1942252713
Name:SLAWSON, JAMES G (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:SLAWSON
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 1:2400 W VILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4901
Mailing Address - Country:US
Mailing Address - Phone:414-527-8191
Mailing Address - Fax:414-527-5069
Practice Address - Street 1:2400 W VILLARD AVE
Practice Address - Street 2:WFHC GLENDALE FAMILY CENTER
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-4901
Practice Address - Country:US
Practice Address - Phone:414-527-8191
Practice Address - Fax:414-527-5069
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1942252713Medicaid
002000163HOtherHUMANA
002000163HOtherHUMANA
WI1942252713Medicaid