Provider Demographics
NPI:1245813799
Name:SLATTON, JESSE JAMES
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:JAMES
Last Name:SLATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JESSE
Other - Middle Name:JAMES
Other - Last Name:SLATTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2116 NATCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-4721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2116 NATCHEZ AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-4721
Practice Address - Country:US
Practice Address - Phone:216-345-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist