Individual
DR. BRUCE C SLAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 758-8019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
158861
NY
208M00000X
Hospitalist Physician
Primary
158861
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00968772
—
NY
Enumeration date
02/06/2006
Last updated
03/31/2021
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