Individual
MATTHEW SLOCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1585 3RD ST, FORT JOHNSON, LA 71459-5102
(419) 764-3404
Mailing address
1585 3RD ST, FORT JOHNSON, LA 71459-5102
(337) 531-3119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
10/07/2024
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