Healthcare Provider Details

I. General information

NPI: 1689668873
Provider Name (Legal Business Name): GREGORY S SKOPEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-353-6632
  • Fax: 319-356-3901
Mailing address:
  • Phone: 319-353-6632
  • Fax: 319-356-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number29592
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: