Provider Demographics
NPI:1881779429
Name:SKARE, ERNEST F II (DC)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:F
Last Name:SKARE
Suffix:II
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 1:25 S 15TH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-3900
Mailing Address - Country:US
Mailing Address - Phone:712-322-3200
Mailing Address - Fax:712-322-3200
Practice Address - Street 1:25 S 15TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3900
Practice Address - Country:US
Practice Address - Phone:712-322-3200
Practice Address - Fax:712-322-3200
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04891111N00000X
NE781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAT74885Medicare UPIN
IA12941Medicare ID - Type UnspecifiedCHIROPRACTOR