# DR LARRY O SKELTON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649458605
- **Authorized official:** DR. LARRY O SKELTON MD (OWNER)
- **Authorized official phone:** 20533712267

## Contact information

- **Practice address:** 16063 HWY 69 SOUTH, MOUNDVILLE, AL 35474
- **Practice address phone:** (205) 371-2267
- **Mailing address:** PO BOX 687, MOUNDVILLE, AL 35474
- **Mailing address phone:** (205) 371-2267
- **Mailing address fax:** (205) 371-9031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8780 | AL | Yes |
| 363L00000X | Nurse Practitioner | 1079822 | AL | — |

## Other

- **Enumeration date:** 02/01/2008
- **Last updated:** 02/01/2008