Provider Demographics
NPI:1356335830
Name:SKAGGS, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SKAGGS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2350 SCENIC DR
Mailing Address - Street 2:SENIOR FRIENDSHIP CENTERS, INC.
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1510
Mailing Address - Country:US
Mailing Address - Phone:941-584-0043
Mailing Address - Fax:941-496-8627
Practice Address - Street 1:2350 SCENIC DR
Practice Address - Street 2:SENIOR FRIENDSHIP CENTERS, INC.
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1510
Practice Address - Country:US
Practice Address - Phone:941-584-0043
Practice Address - Fax:941-496-8627
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLLL604207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC44876Medicare UPIN
FLU4787AMedicare ID - Type Unspecified