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General NPI Number Information
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NPI Number | 1386061174
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Entity Type | Organization
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Legal Business Name | FAMILY PSYCHIATRY OF MAINE PA LLC
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 253 MAIN ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6800
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Country | US
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Telephone | 207-650-1393
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Fax | 888-538-7919
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Provider Business Mailing Address
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Address Line | 253 MAIN ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6800
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Country | US
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Telephone | 207-650-1393
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Fax | 888-538-7919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY SKINNER
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Credential | MD
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Telephone | 207-650-1393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD18501
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD18501
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License Number State | ME
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