Provider Demographics
NPI:1316134448
Name:ROBERT R. SLATER, JR, MD. INCORPORATED
Entity type:Organization
Organization Name:ROBERT R. SLATER, JR, MD. INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:916-404-4400
Mailing Address - Street 1:1568 CREEKSIDE DR.
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:916-404-4400
Mailing Address - Fax:916-790-5924
Practice Address - Street 1:1568 CREEKSIDE DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-404-4400
Practice Address - Fax:916-790-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80954207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty