Provider Demographics
NPI:1730474842
Name:SKAGGS, JOHN D (ATP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:SKAGGS
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6147
Mailing Address - Country:US
Mailing Address - Phone:254-772-6970
Mailing Address - Fax:254-772-5652
Practice Address - Street 1:6931 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6147
Practice Address - Country:US
Practice Address - Phone:254-772-6970
Practice Address - Fax:254-772-5652
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other