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Individual

GARY OWEN SKINNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
18675 EAST 39TH STREET, SUITE M, INDEPENDENCE, MO 64057-1762
(816) 795-9911
(816) 795-1911
Mailing address
18675 EAST 39TH STREET, SUITE M, INDEPENDENCE, MO 64057-1762
(816) 795-9911
(816) 795-1911

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0516202
KS
208D00000X
General Practice Physician
692
HI
208D00000X
General Practice Physician
Primary
R5996
MO

Other

Enumeration date
09/26/2006
Last updated
07/08/2007
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