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General NPI Number Information
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NPI Number | 1518153089
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Entity Type | Organization
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Legal Business Name | HUNTINGTON RETINA CENTER, INC.
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 1616 13TH AVE SUITE 3 B&C
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City | HUNTINGTON
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State | WV
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Zip | 25701-3840
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Country | US
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Telephone | 304-525-1404
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Fax | 304-523-9763
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Provider Business Mailing Address
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Address Line | 1616 13TH AVE SUITE 3 B&C
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City | HUNTINGTON
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State | WV
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Zip | 25701-3840
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Country | US
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Telephone | 304-525-1404
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Fax | 304-523-9763
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | STEPHANIE ANN SKOLIK
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Credential | M.D.
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Telephone | 304-525-1404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 15984
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License Number State | WV
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