Provider Demographics
NPI:1003835612
Name:SLAUGHTER, ROBERT D (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:SLAUGHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 PETER BRYCE BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-7419
Mailing Address - Country:US
Mailing Address - Phone:205-348-1770
Mailing Address - Fax:205-348-5145
Practice Address - Street 1:850 PETER BRYCE BLVD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-348-1770
Practice Address - Fax:205-348-5145
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD12825208M00000X
AL128252084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000005851Medicaid
MS124901OtherMISSISSIPPI MEDICAID
ALC70405OtherVIVA
AL000036861Medicaid
AL051504057OtherBLUE CROSS
AL000005851OtherBLUE CROSS
AL000013437OtherHEALTHSPRING OF ALABAMA
AL000013438OtherHEALTHSPRING OF ALABAMA
AL000036861OtherBLUE CROSS
AL000013438OtherHEALTHSPRING OF ALABAMA
AL000005851Medicaid
AL000036861Medicaid
AL130014759Medicare PIN