Provider Demographics
NPI:1538458096
Name:JOHN C SKILLINGS MD,PA
Entity Type:Organization
Organization Name:JOHN C SKILLINGS MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARVER
Authorized Official - Last Name:SKILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-335-8550
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-0338
Mailing Address - Country:US
Mailing Address - Phone:585-335-8550
Mailing Address - Fax:585-335-9452
Practice Address - Street 1:111 CLARA BARTON ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9503
Practice Address - Country:US
Practice Address - Phone:585-335-8550
Practice Address - Fax:585-335-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124859208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty