Provider Demographics
NPI:1528349941
Name:SKELTON, LAURA (OD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:853 OLD WINSTON RD
Mailing Address - Street 2:PO BOX 306
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7143
Mailing Address - Country:US
Mailing Address - Phone:336-993-3930
Mailing Address - Fax:336-993-3979
Practice Address - Street 1:2100 W CORNWALLIS DR STE J
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7015
Practice Address - Country:US
Practice Address - Phone:336-288-3937
Practice Address - Fax:336-288-8177
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2247152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist