Healthcare Provider Details
I. General information
NPI: 1902329121
Provider Name (Legal Business Name): ROBERT BARNETT SKINNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/19/2017
Last Update Date: 07/21/2022
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4777 E GALBRAITH RD
CINCINNATI OH
45236-2725
US
IV. Provider business mailing address
86 W UNDERWOOD ST STE 201
ORLANDO FL
32806-1110
US
V. Phone/Fax
- Phone: 513-558-5281
- Fax: 513-558-5791
- Phone: 321-841-5142
- Fax: 407-245-7059
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | TRN25706 |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 35.141952 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: