Provider Demographics
NPI:1548694904
Name:SKIPWORTH, JOSEPH DEE (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DEE
Last Name:SKIPWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 JUDIO ROAD
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717
Mailing Address - Country:US
Mailing Address - Phone:270-433-6177
Mailing Address - Fax:
Practice Address - Street 1:1100 JUDIO ROAD
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717
Practice Address - Country:US
Practice Address - Phone:270-433-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine