Individual
STEPHEN CHAD SKIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240
(706) 882-1411
Mailing address
115 SPRINGWATER SHRS, NEWNAN, GA 30265-3819
(937) 430-9026
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
80578
GA
Other
Enumeration date
04/13/2015
Last updated
07/20/2018
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