Organization
BANNOCK INPATIENT SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J SLEPIN MD (PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(469) 401-2386
Mailing address
13737 NOEL RD STE 1600, DALLAS, TX 75240-1374
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/22/2015
Last updated
12/28/2015
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