MEDICARE: STEWART ALLEN SKIPPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME41089	FL
2	2086S0129X	Vascular Surgery Physician	ME41089	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00039972	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	30602	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1427091073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEWART ALLEN SKIPPER MD

Provider Business Mailing Address
First Line	:	4301 SUN N LAKE BLVD
Second Line	:	SUITE 103
City	:	SEBRING
State	:	FL
Zip	:	33872-2162
Country	:	US
Telephone Number	:	863-385-1900
Fax Number	:	863-385-9229

Provider Business Practice Location Address
First Line	:	4301 SUN N LAKE BLVD
Second Line	:	SUITE 103
City	:	SEBRING
State	:	FL
Zip	:	33872-2162
Country	:	US
Telephone Number	:	863-385-1900
Fax Number	:	863-385-9229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/23/2013

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Directions to “ STEWART ALLEN SKIPPER MD” Practice Location

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