Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301108205 | MI |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 327829 | LA |
NPI | 1043699002 |
---|---|
Provider Name | Dr. Timothy John Skalak |
First Address | New Orleans, LA 70118-5720 |
Second Address | New Orleans, LA 70118-5798 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2015 |
Last Update Date | 28/10/2021 |