Healthcare Provider Details

I. General information

NPI: 1417038449
Provider Name (Legal Business Name): MARK LOUIS SKORY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 E MIDLAND RD SUITE A
AUBURN MI
48611-9751
US

IV. Provider business mailing address

312 E MIDLAND RD SUITE A
AUBURN MI
48611-9751
US

V. Phone/Fax

Practice location:
  • Phone: 989-662-4425
  • Fax: 989-662-3343
Mailing address:
  • Phone: 989-662-4425
  • Fax: 989-662-3343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: