Healthcare Provider Details

I. General information

NPI: 1194769273
Provider Name (Legal Business Name): KATHERINE KNESS SKAGGS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 PEAK ONE DRIVE SUITE #260
FRISCO CO
80443
US

IV. Provider business mailing address

PO BOX 1292
FRISCO CO
80443-1292
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-5771
  • Fax: 970-262-2196
Mailing address:
  • Phone: 970-668-5771
  • Fax: 970-262-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number31388
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number31388-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: