Provider Demographics
NPI:1134272545
Name:SLOCUM, DAVID ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ASHLEY
Last Name:SLOCUM
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 1:16 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2416
Mailing Address - Country:US
Mailing Address - Phone:518-257-2277
Mailing Address - Fax:
Practice Address - Street 1:235 PEACHTREE ST NE
Practice Address - Street 2:NORTH TOWER, SUITE 2100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1401
Practice Address - Country:US
Practice Address - Phone:770-994-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057496207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine