Slade, Lance E

Slade, Lance E is an individual health care provider with primary practice located at 550 Professional Dr , Macon GA 31201-1411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Slade, Lance E can be contacted via phone (478) 741-3007.

Contact Information

Primary practice address
550 Professional Dr Macon GA 31201-1411
Fax: (478) 330-6288
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 52488 Georgia

Profile Details

NPI number 1699858514
LBN Legal business name Slade, Lance E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Dec 29th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699858514 NPPES
Georgia MEDICAID 318185311A

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