Provider Demographics
NPI:1568219517
Name:SKUBINNA, JOEL MARION
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:MARION
Last Name:SKUBINNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12916 S LAND CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2001
Mailing Address - Country:US
Mailing Address - Phone:206-231-7418
Mailing Address - Fax:
Practice Address - Street 1:24962 OKAY RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:OK
Practice Address - Zip Code:74873-6504
Practice Address - Country:US
Practice Address - Phone:405-253-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist