Individual
DR. MARK SULLIVAN SLAUGHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 ABRAHAM FLEXNER WAY, SUITE 1200, LOUISVILLE, KY 40202-3841
(502) 561-2180
(502) 561-2190
Mailing address
201 ABRAHAM FLEXNER WAY, SUITE 1200, LOUISVILLE, KY 40202-3841
(502) 561-2180
(502) 561-2190
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01043482A
IN
208600000X
Surgery Physician
036075781
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01043482A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036075781
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
42157
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BCBS
IL
05
—
036075781
—
IL
05
—
200061040A
—
IN
05
—
200061040B
—
IN
05
—
200061040C
—
IN
05
—
200061040D
—
IN
05
—
200061040E
—
IN
Enumeration date
09/21/2005
Last updated
07/09/2020
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