Organization
SLOCUM DICKSON MEDICAL GROUP PLLC
Active
Organization
SLOCUM DICKSON MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN D. EADLINE MD (PRESIDENT)
(315) 798-1700
Entity
Organization
Contact information
Practice address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 798-1700
(315) 798-1707
Mailing address
1729 BURRSTONE RD, NEW HARTFORD, NY 13413-1001
(315) 798-1700
(315) 798-1707
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
47440
NY
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02995013
—
NY
Enumeration date
11/02/2005
Last updated
06/11/2021
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