Individual
ROBERT L SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3451 GOODMAN RD, STE 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
(662) 890-8899
Mailing address
3451 GOODMAN RD, STE 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
(662) 890-8899
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16397
MS
207Q00000X
Family Medicine Physician
DO0000001485
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080194851
MEDICARE RAILROAD
MS
Enumeration date
06/01/2005
Last updated
06/21/2013
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