Individual
GREGORY GORDON SKAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 WALLACE AVE, LEITCHFIELD, KY 42754-2414
(270) 259-9651
(270) 259-9582
Mailing address
910 WALLACE AVE, LEITCHFIELD, KY 42754-2414
(270) 259-9651
(270) 259-9582
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24093
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203767609
PHCS
KY
01
—
207677609
CIGNA
KY
01
—
2434505000
PASSPORT ADVANTAGE
KY
01
—
4349009
ATENA
KY
05
—
64240930
—
KY
Enumeration date
05/15/2006
Last updated
02/01/2012
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