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NPI Code Detail

MEDICARE: DANIEL J SKARZYNSKI M.D.

MEDICARE: DANIEL J SKARZYNSKI 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
1207RC0000XCardiovascular Disease Physician25209MS
2207RC0000XCardiovascular Disease PhysicianCP200550OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44042635OTHERTNBCBS TN

General Provider Information

NPI Number : 1104988583
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL J SKARZYNSKI M.D.
Provider Business Mailing Address
First Line : 5003 HARDY ST STE 200
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1331
Country : US
Telephone Number : 601-261-5700
Fax Number : 601-261-5777
Provider Business Practice Location Address
First Line : 1775 THOMPSON RD
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2198
Country : US
Telephone Number : 541-269-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 10/09/2020

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