Provider Demographics
NPI:1699969485
Name:SKELTON CHIROPRACTIC INC.
Entity type:Organization
Organization Name:SKELTON CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SKELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-938-7246
Mailing Address - Street 1:1601 HIGHWAY 77 NORTH
Mailing Address - Street 2:PO BOX 938
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75168-0938
Mailing Address - Country:US
Mailing Address - Phone:972-938-7246
Mailing Address - Fax:972-935-0930
Practice Address - Street 1:1601 N HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-7812
Practice Address - Country:US
Practice Address - Phone:972-938-7246
Practice Address - Fax:972-935-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6118261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001677601Medicaid
TX001677601Medicaid
TXU39629Medicare UPIN