MEDICARE: DR. TRACY TODD SKIPTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	22560	NE

General Provider Information

NPI Number	:	1053317487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACY TODD SKIPTON M.D.

Provider Business Mailing Address
First Line	:	1352 AUTUMN PINES DR
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-2698
Country	:	US
Telephone Number	:	850-377-1251
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVAL HOSPITAL JACKSONVILLE 2080 CHILD STREET
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32214-5600
Country	:	US
Telephone Number	:	904-546-6351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/10/2020

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