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NPI Code Detail

MEDICARE: DR. HENRY C. SKINNER MD

MEDICARE: DR. HENRY C. SKINNER MD
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
12084P0800XPsychiatry Physician222511MA
22084P0804XChild & Adolescent Psychiatry Physician222511MA
32084P0804XChild & Adolescent Psychiatry PhysicianMD18501ME

General Provider Information

NPI Number : 1619949526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HENRY C. SKINNER MD
Provider Business Mailing Address
First Line : 253 MAIN ST
Second Line :
City : YARMOUTH
State : ME
Zip : 04096-6800
Country : US
Telephone Number : 207-650-1393
Fax Number :
Provider Business Practice Location Address
First Line : 1155 LISBON ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-5025
Country : US
Telephone Number : 207-783-9141
Fax Number : 207-376-3808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 09/20/2018

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