Individual
DR. KELLY DEAN SKANCHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 CRAVEN ST BLDG 3300, NAVAL HEALTH CLINIC NAVAL STATION SAN DIEGO, SAN DIEGO, CA 92136-5599
(619) 556-5936
(619) 556-9419
Mailing address
2450 CRAVEN ST BLDG 3300, NAVAL HEALTH CLINIC NAVAL BASE SAN DIEGO, SAN DIEGO, CA 92136-5599
(619) 556-5936
(619) 556-9419
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
GFE83510
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
MD044935L
PA
Other
Enumeration date
08/18/2005
Last updated
04/29/2014
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