Provider Demographics
NPI:1013337674
Name:SKIDMORE, ELIZABETH FAYE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FAYE
Last Name:SKIDMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:FAYE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1701 WESTCHESTER DR STE 850
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-702-2007
Mailing Address - Fax:
Practice Address - Street 1:201 W HOLLY HILL RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360
Practice Address - Country:US
Practice Address - Phone:336-475-9164
Practice Address - Fax:336-475-6619
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine