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General NPI Number Information
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NPI Number | 1699456772
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Entity Type | Organization
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Legal Business Name | GARY SKANKEY LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 2931 N TENAYA WAY
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City | LAS VEGAS
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State | NV
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Zip | 89128-0456
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Country | US
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Telephone | 702-448-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 CATHEDRAL ROCK DR STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89128-0430
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Country | US
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Telephone | 702-448-2544
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY SKANKEY
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Credential | MD
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Telephone | 941-380-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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