MEDICARE: MARK WESLEY EPPS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	2210	SC

General Provider Information

NPI Number	:	1083793293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK WESLEY EPPS PA-C

Provider Business Mailing Address
First Line	:	1113 44TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5783
Country	:	US
Telephone Number	:	843-449-6261
Fax Number	:	843-449-8171

Provider Business Practice Location Address
First Line	:	1113 44TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5783
Country	:	US
Telephone Number	:	434-496-2618
Fax Number	:	843-449-8171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	01/19/2026

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