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Individual

LAURA DAWN GATSOS SKORACKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
460 W 10TH AVE, COLUMBUS, OH 43210
(614) 293-8074
Mailing address
320 W 10TH AVE, B250, COLUMBUS, OH 43210-1280
(614) 366-5174

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA02098
TX
363AM0700X
Medical Physician Assistant
Primary
50004177
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
180584801
TX
01
87N109
BCBS
TX
01
970011588
RR MEDICARE
TX
Enumeration date
07/09/2006
Last updated
12/10/2014
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