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Ryan Gregory Skinner
Military Health Care Provider in O Fallon, Illinois
NPI 1699472282

Ryan Gregory Skinner is a Military Health Care Provider based in O Fallon, IL. Ryan Gregory Skinner practices in O Fallon, IL. The NPI Number for Ryan Gregory Skinner is 1699472282 and holds a License No. (Illinois).

The current practice location address for Ryan Gregory Skinner is 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL and can be reached out via phone at 618-256-9355 and via fax at 618-206-2332.

Location: 3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL, 62269-1284
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699472282
Provider Name
Ryan Gregory Skinner
Credential
Provider Entity Type
Individual
Gender
Male
Address
3 Saint Elizabeth Blvd Ste 4000, O Fallon, IL, 62269-1284
Phone Number
618-256-9355
Fax Number
618-206-2332
Provider Enumeration Date
02/14/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3 Saint Elizabeth Blvd Ste 4000
City
O Fallon
State
Illinois
Zip
62269-1284
Phone Number
618-256-9355
Fax Number
618-206-2332
person
Provider Business Mailing Address Details
Address
3 Saint Elizabeth Blvd Ste 4000
City
O Fallon
State
Illinois
Zip
62269-1284
Phone Number
618-256-9355
Fax Number
618-206-2332
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
125.082940 (Illinois)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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