Healthcare Provider Details

I. General information

NPI: 1538228457
Provider Name (Legal Business Name): JAMIE C SKAGGS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. JAMIE C SKAGGS III

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 NORTH COUNTRY ROAD SUITE 4
MILLER PLACE NY
11764
US

IV. Provider business mailing address

1500 MIDDLE COUNTRY RD STE 3
CENTEREACH NY
11720-3500
US

V. Phone/Fax

Practice location:
  • Phone: 631-331-2272
  • Fax: 631-331-4398
Mailing address:
  • Phone: 631-543-1440
  • Fax: 631-543-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX0082131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: