MEDICARE: GARY SKANKEY, MD, PC

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

General Provider Information

NPI Number	:	1992231500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARY SKANKEY, MD, PC

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	:	702-723-4124
Fax Number	:	702-867-0066

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	:	MANAGER
Name	:	CARLA REVILLA
Credential	:
Telephone Number	:	719-229-3849

Provider Enumeration Date	:	05/03/2017
Last Update Date	:	02/23/2024

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