Provider Demographics
NPI:1275913733
Name:SLOCUM, ALEXANDER HENRY JR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:HENRY
Last Name:SLOCUM
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:875 GREENLAND RD UNIT C8
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4163
Mailing Address - Country:US
Mailing Address - Phone:603-956-6059
Mailing Address - Fax:603-956-6091
Practice Address - Street 1:875 GREENLAND RD UNIT C8
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4163
Practice Address - Country:US
Practice Address - Phone:603-777-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-31
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10163216208200000X
WI67919-202086S0122X
NH209082086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery