Provider Demographics
NPI:1922231414
Name:SKARPHOL, DARRELL PETER (MD)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:PETER
Last Name:SKARPHOL
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 1:2480 EDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-4813
Mailing Address - Country:US
Mailing Address - Phone:920-468-7396
Mailing Address - Fax:920-468-7396
Practice Address - Street 1:2480 EDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-4813
Practice Address - Country:US
Practice Address - Phone:920-468-7396
Practice Address - Fax:920-468-7396
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17649-020207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology