Individual
KENT EDWARD SKOGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4612 LAUREL AVE, LAKE ISABELLA, CA 93240
(760) 379-2681
Mailing address
8045 LIST COUNTRY RD, CARSON CITY, NV 89703-9528
(775) 885-2113
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A39437
CA
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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