Slack, Christopher Lee

Slack, Christopher Lee is an individual health care provider with primary practice located at 4632 S 25Th St , Fort Pierce FL 34981-5057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as his primary health care specialty. Slack, Christopher Lee can be contacted via phone (772) 464-9595.

Contact Information

Primary practice address
4632 S 25Th St Fort Pierce FL 34981-5057
Phone: (772) 464-9595
Fax: (772) 464-9582
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X ME84369 Florida
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 36380 Colorado

Profile Details

NPI number 1982613717
LBN Legal business name Slack, Christopher Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Jul 9th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982613717 NPPES
Florida MEDICAID 264157700

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