Provider Demographics
NPI:1831374693
Name:SKURLA, RICHARD (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SKURLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 LUISA ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7001
Mailing Address - Country:US
Mailing Address - Phone:505-629-4126
Mailing Address - Fax:
Practice Address - Street 1:1301 LUISA ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7001
Practice Address - Country:US
Practice Address - Phone:505-629-4126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-899-89204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM