Basic Information
Provider Information
NPI: 1699234351
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLATTON
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2004 HAYES ST STE 800
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032659
CountryCode: US
TelephoneNumber: 6153290570
FaxNumber:  
Practice Location
Address1: 605 GLENWOOD DR STE 200
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374041130
CountryCode: US
TelephoneNumber: 4236981844
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/12/2019
LastUpdateDate: 05/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XAPN23049TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363LA2200XRN279101GAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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