Provider Demographics
NPI:1265077234
Name:SLEZAK, HANNAH ALEXIS (PA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ALEXIS
Last Name:SLEZAK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ALEXIS
Other - Last Name:TUNKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 131329
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-6329
Mailing Address - Country:US
Mailing Address - Phone:205-271-8541
Mailing Address - Fax:
Practice Address - Street 1:705 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1156
Practice Address - Country:US
Practice Address - Phone:256-492-0375
Practice Address - Fax:256-492-9811
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9544207RH0003X
TN9354363A00000X
ALPA.2142363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology