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General NPI Number Information
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NPI Number | 1154365815
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH SKARNULIS O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 2129 W HOUGHTON LAKE DR
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City | HOUGHTON LAKE
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State | MI
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Zip | 48629-8236
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Country | US
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Telephone | 989-366-6344
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Fax | 989-366-6390
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Provider Business Mailing Address
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Address Line | 8154 BEL CHERRIE DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-1637
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Country | US
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Telephone | 231-633-4210
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Fax | 989-366-6390
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | LS004270
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License Number State | MI
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