Healthcare Provider Details

I. General information

NPI: 1518153089
Provider Name (Legal Business Name): HUNTINGTON RETINA CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 13TH AVE SUITE 3 B&C
HUNTINGTON WV
25701-3840
US

IV. Provider business mailing address

1616 13TH AVE SUITE 3 B&C
HUNTINGTON WV
25701-3840
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-1404
  • Fax: 304-523-9763
Mailing address:
  • Phone: 304-525-1404
  • Fax: 304-523-9763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number15984
License Number StateWV

VIII. Authorized Official

Name: STEPHANIE ANN SKOLIK
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 304-525-1404