Provider Demographics
NPI:1902552441
Name:MATTHEW D. SKAHAN, O.D., P.A.
Entity Type:Organization
Organization Name:MATTHEW D. SKAHAN, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SKAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:620-363-4341
Mailing Address - Street 1:1010 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-1831
Mailing Address - Country:US
Mailing Address - Phone:620-363-4341
Mailing Address - Fax:
Practice Address - Street 1:115 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032-9405
Practice Address - Country:US
Practice Address - Phone:785-448-6879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty