Provider Demographics
NPI:1558324467
Name:SKINNER, ALISON C (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:C
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:N
Other - Last Name:CHRISTIAN-TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3253 TAYLOR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2403
Mailing Address - Country:US
Mailing Address - Phone:757-686-5673
Mailing Address - Fax:757-686-8694
Practice Address - Street 1:3253 TAYLOR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-2403
Practice Address - Country:US
Practice Address - Phone:757-686-5673
Practice Address - Fax:757-686-8694
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05149OtherGROUP PTAN
VA5639093Medicaid
VAG88586Medicare UPIN
VA080007000Medicare PIN
VA080139597Medicare PIN