Individual
JOHN BENJAMIN SLADE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535
(707) 423-3987
(707) 423-5356
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3987
(707) 423-5356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A35154
CA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
A35154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A351541
—
CA
Enumeration date
09/27/2006
Last updated
06/18/2019
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