Individual
JANTZEN T SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
199 E. MAIN ST., FARMINGTON, AR 72730-3077
(479) 267-1001
(479) 267-1026
Mailing address
PO BOX 550, LOWELL, AR 72745
(479) 463-7775
(479) 463-7187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
9865992-1205
UT
207Q00000X
Family Medicine Physician
Primary
E-11402
AR
Other
Enumeration date
05/29/2015
Last updated
07/19/2018
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