Healthcare Provider Details

I. General information

NPI: 1811378516
Provider Name (Legal Business Name): CAILEIGH A SKOGG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAILEIGH A GROVE

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 MIDDLE ST
FALL RIVER MA
02721-1733
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 508-828-7000
  • Fax: 508-999-9442
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA102795
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: