Provider Demographics
NPI:1629048319
Name:SKEENS, JOSEPH L (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:SKEENS
Suffix:
Gender:M
Credentials:MD
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 1006
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1006
Mailing Address - Country:US
Mailing Address - Phone:866-494-8267
Mailing Address - Fax:
Practice Address - Street 1:2483 HIGHWAY 644
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230
Practice Address - Country:US
Practice Address - Phone:606-638-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY380072085R0202X
WV173042085R0202X
OH350808882085R0202X
NY2655002085R0202X
FLME648152085R0202X
IL0361335922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2046333Medicaid
WVP00012901OtherRAILROAD MEDICARE
KYP00023465OtherRAILROAD MEDICARE
WV000675665OtherBCBS
WV012001000Medicaid
KY64942014Medicaid
KYP00277329OtherRAILROAD MEDICARE
KY000000391033OtherBCBS
KY000000390832OtherBCBS
KY00458001Medicare PIN
KY0766802Medicare PIN
OH4149402Medicare PIN
KYP00277329OtherRAILROAD MEDICARE
KY000000391033OtherBCBS
E88348Medicare UPIN
KYP00023465OtherRAILROAD MEDICARE
KY64942014Medicaid