Healthcare Provider Details

I. General information

NPI: 1598866105
Provider Name (Legal Business Name): JOHN T. SKOWRONSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 LOUISIANA ST
LITTLE ROCK AR
72206-1429
US

IV. Provider business mailing address

1619 LOUISIANA ST
LITTLE ROCK AR
72206-1429
US

V. Phone/Fax

Practice location:
  • Phone: 501-371-0582
  • Fax:
Mailing address:
  • Phone: 501-371-0582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberARC6007
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: