Provider Demographics
NPI:1255447066
Name:SKIPPER, STEPHEN NORWOOD (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NORWOOD
Last Name:SKIPPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4410
Mailing Address - Country:US
Mailing Address - Phone:843-383-2340
Mailing Address - Fax:843-383-2341
Practice Address - Street 1:600 W. CAROLINA AVE.
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550
Practice Address - Country:US
Practice Address - Phone:843-383-2340
Practice Address - Fax:843-383-2341
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC00808430OtherRAIL ROAD PTAN (INDIVIDUAL)
SC00808430OtherRAIL ROAD PTAN (INDIVIDUAL)