Provider Demographics
NPI:1982676441
Name:SLATOSKY, JOHN JAMES JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAMES
Last Name:SLATOSKY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:604 W ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317
Mailing Address - Country:US
Mailing Address - Phone:336-498-1200
Mailing Address - Fax:336-498-1207
Practice Address - Street 1:604 W ACADEMY ST
Practice Address - Street 2:
Practice Address - City:RANDLEMAN
Practice Address - State:NC
Practice Address - Zip Code:27317
Practice Address - Country:US
Practice Address - Phone:336-498-1200
Practice Address - Fax:336-498-1207
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC202600853OtherCIGNA
NC7031061OtherAETNA
NCE2071OtherMEDCOST
NC2152142OtherFIRST HEALTH/CCN
NC202600853OtherHCS
NC202600853OtherPHCS
NC2348546OtherMEDICARE
NC1212UOtherBCBS
NC127074OtherFOCUS
NC202600853OtherGREAT WEST
NC108086OtherUHC
NC5901190Medicaid
NC5901190Medicaid
NCE2071OtherMEDCOST