Basic Information
| Provider Information | |||||||||
| NPI: | 1669762910 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLOKAN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1910 SASSAFRAS ST | ||||||||
| Address2: | STE 100 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165022716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144387208 | ||||||||
| FaxNumber: | 8144388062 | ||||||||
| Practice Location | |||||||||
| Address1: | 2580 CONSTITUTION BLVD | ||||||||
| Address2: | |||||||||
| City: | BEAVER FALLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150101294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247736844 | ||||||||
| FaxNumber: | 7247707953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS015662 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1025973200005 | 05 | PA | MEDICAID |