Provider Demographics
NPI:1083866677
Name:SKELTON, THOMAS SPENCER (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SPENCER
Last Name:SKELTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:POLLOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28573-0068
Mailing Address - Country:US
Mailing Address - Phone:252-633-2081
Mailing Address - Fax:252-633-3446
Practice Address - Street 1:701 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5239
Practice Address - Country:US
Practice Address - Phone:252-633-2081
Practice Address - Fax:252-633-3446
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7878208600000X
TXTMBPIT#BP10028995390200000X
NC2020-03863208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program