Provider Demographics
NPI:1083793293
Name:EPPS, MARK WESLEY (PA-C)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:WESLEY
Last Name:EPPS
Suffix:
Gender:
Credentials:PA-C
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Mailing Address - Street 1:1113 44TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5783
Mailing Address - Country:US
Mailing Address - Phone:843-449-6261
Mailing Address - Fax:843-449-8171
Practice Address - Street 1:1113 44TH AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5783
Practice Address - Country:US
Practice Address - Phone:434-496-2618
Practice Address - Fax:843-449-8171
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2025-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-00408363A00000X
SC2210363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant