Provider Demographics
NPI:1013152404
Name:DR SLOVACHEK LLC
Entity type:Organization
Organization Name:DR SLOVACHEK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SLOVACHEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-490-4610
Mailing Address - Street 1:1877 LAKES EDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8091
Mailing Address - Country:US
Mailing Address - Phone:812-490-4610
Mailing Address - Fax:812-490-4610
Practice Address - Street 1:3700 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47750-0001
Practice Address - Country:US
Practice Address - Phone:812-485-7111
Practice Address - Fax:812-485-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-13
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056372207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty