Individual
PHILIP SLOCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 MCINTOSH CIR, STE 302, JOPLIN, MO 64804-3615
(417) 347-8315
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-8315
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
200200143
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
44373
TX
207RP1001X
Pulmonary Disease Physician
Primary
200200143
MO
207RP1001X
Pulmonary Disease Physician
44373
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
200200143
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329061101
—
TX
01
—
8ED501
BCBS
TX
01
—
P01447536
RAILROAD MEDICARE
TX
Enumeration date
08/01/2012
Last updated
04/01/2016
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