Individual
DR. SKYLER SHANE SHIPPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-4696
Mailing address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-4696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRM-1552
ID
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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