Provider Demographics
NPI:1417063439
Name:SLEPIN, MARK JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JEFFREY
Last Name:SLEPIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 W CEDAR ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-4910
Mailing Address - Country:US
Mailing Address - Phone:469-401-2386
Mailing Address - Fax:877-411-5650
Practice Address - Street 1:350 W CEDAR ST
Practice Address - Street 2:SUITE 400
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-4910
Practice Address - Country:US
Practice Address - Phone:469-401-2386
Practice Address - Fax:877-411-5650
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0068339207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
32319Medicare PIN
D73337Medicare UPIN