Provider Demographics
NPI:1851312417
Name:SKLAR, JOSEPH H (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:H
Last Name:SKLAR
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 1:300 BIRNIE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1107
Mailing Address - Country:US
Mailing Address - Phone:413-785-4666
Mailing Address - Fax:413-846-4756
Practice Address - Street 1:300 BIRNIE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1107
Practice Address - Country:US
Practice Address - Phone:413-785-4666
Practice Address - Fax:413-846-4756
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46549207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200011016Medicaid
MAB99086Medicare UPIN
MAJ04083Medicare PIN