MEDICARE: DR. GARY RICHARD SKANKEY 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	207RI0200X	Infectious Disease Physician	6415	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952386468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY RICHARD SKANKEY M.D.

Provider Business Mailing Address
First Line	:	7200 CATHEDRAL ROCK DR STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0430
Country	:	US
Telephone Number	:	702-737-0740
Fax Number	:	702-737-1402

Provider Business Practice Location Address
First Line	:	7200 CATHEDRAL ROCK DR STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0430
Country	:	US
Telephone Number	:	702-723-4124
Fax Number	:	702-867-0066

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	11/08/2023

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