Provider Demographics
NPI:1407198690
Name:SOUYOUL, SKYLAR AMANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:SKYLAR
Middle Name:AMANDA
Last Name:SOUYOUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:145 ROBERT E LEE BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2593
Mailing Address - Country:US
Mailing Address - Phone:504-777-3047
Mailing Address - Fax:
Practice Address - Street 1:538 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5812
Practice Address - Country:US
Practice Address - Phone:978-691-5690
Practice Address - Fax:978-225-7837
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA302310207N00000X
MA282659207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology