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General NPI Number Information
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NPI Number | 1790150514
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Entity Type | Organization
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Legal Business Name | POCATELLO INPATIENT SERVICES PLLC
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 777 HOSPITAL WAY
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City | POCATELLO
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State | ID
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Zip | 83201-5175
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Country | US
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Telephone | 469-401-2386
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Fax |
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Provider Business Mailing Address
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Address Line | 13737 NOEL RD #1600
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City | DALLAS
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State | TX
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Zip | 75240-1331
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Country | US
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Telephone | 469-401-2386
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK J SLEPIN
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Credential | MD
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Telephone | 469-401-2386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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