Dr. Christopher Lee Slack
Facial Plastic Surgeon
4632 S 25th St
Fort Pierce
, Florida 34981-5057
Dr. Christopher Lee Slack
Facial Plastic Surgeon
4632 S 25th St
Fort Pierce
, Florida 34981-5057
(772) 464-9582
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Christopher Lee Slack
- 4632 S 25th St
- Fort Pierce, FL
- Zip : 34981-5057
- Fax : (772) 464-9582
- Phone : (772) 464-9595
Second Address
- Dr. Christopher Lee Slack
- 4632 S 25th St
- Fort Pierce, FL
- Zip : 34981-5057
- Fax : (772) 464-9582
- Phone : (772) 464-9595
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207YS0123X | Facial Plastic Surgeon | 36380 | CO |
| Y | 207YS0123X | Facial Plastic Surgeon | ME84369 | FL |
National Provider Identifier
| NPI | 1982613717 |
|---|---|
| Provider Name | Dr. Christopher Lee Slack |
| First Address | Fort Pierce, FL 34981-5057 |
| Second Address | Fort Pierce, FL 34981-5057 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/08/2006 |
| Last Update Date | 09/07/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 264157700 | (05) | FL |
| H70332 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.