Provider Demographics
NPI:1225533201
Name:SKAGGS, JOSHUA PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:PAUL
Last Name:SKAGGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8454 E ROAD 20
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KS
Mailing Address - Zip Code:67880-8339
Mailing Address - Country:US
Mailing Address - Phone:801-678-5782
Mailing Address - Fax:
Practice Address - Street 1:2502 N JOHN ST STE B
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-3073
Practice Address - Country:US
Practice Address - Phone:620-271-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13717111N00000X
KS01-05897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor