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Individual

JEFFREY SLAVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2850 OLYMPUS DRIVE, POCATELLO, ID 83201-2271
(208) 239-1905
(208) 239-3696
Mailing address
P.O. BOX 4168, POCATELLO, ID 83205-4168
(208) 239-1035
(208) 239-3626

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2608
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02808886
NY
05
3124453
NH
05
6704808
VT
Enumeration date
08/09/2006
Last updated
12/11/2025
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