Provider Demographics
NPI:1265537898
Name:SKIBELL, BENTLEY C (MD)
Entity type:Individual
Prefix:DR
First Name:BENTLEY
Middle Name:C
Last Name:SKIBELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7245 E OSBORN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6443
Mailing Address - Country:US
Mailing Address - Phone:480-994-5012
Mailing Address - Fax:480-990-7364
Practice Address - Street 1:7245 E OSBORN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6443
Practice Address - Country:US
Practice Address - Phone:480-994-5012
Practice Address - Fax:480-990-7364
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
AZ36243207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ167974Medicaid
AZH57374Medicare UPIN
AZ8G2381Medicare PIN