Provider Demographics
NPI:1376552737
Name:SKUPNY, CURTIS W (DPM)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:W
Last Name:SKUPNY
Suffix:
Gender:M
Credentials:DPM
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 61397
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-1397
Mailing Address - Country:US
Mailing Address - Phone:239-482-7100
Mailing Address - Fax:239-482-4209
Practice Address - Street 1:13761 MCGREGOR BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-6120
Practice Address - Country:US
Practice Address - Phone:239-482-7100
Practice Address - Fax:239-482-4209
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1727213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29696100Medicaid
FLT55633Medicare UPIN
FL29696100Medicaid