Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 42156 | KY |
NPI | 1164562526 |
---|---|
Provider Name | Sean Skinner |
First Address | Lexington, KY 40536-0298 |
Second Address | Lexington, KY 40536-0298 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 19/08/2016 |