Basic Information
| Provider Information | |||||||||
| NPI: | 1932319878 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLOAN | ||||||||
| FirstName: | DEVIN | ||||||||
| MiddleName: | JOSHUA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 77 E THOMAS RD STE 230 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850123100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025570007 | ||||||||
| FaxNumber: | 6025570002 | ||||||||
| Practice Location | |||||||||
| Address1: | 20601 N 19TH AVE STE 115 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850272646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025570055 | ||||||||
| FaxNumber: | 6235870499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 04/01/2019 | ||||||||
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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 | 2085R0001X | 38187 | AZ | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | P01388504 | 01 | AZ | RR MEDICARE | OTHER | 345228 | 05 | AZ | MEDICAID |