Organization
DR LARRY O SKELTON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY O SKELTON MD (OWNER)
20533712267
Entity
Organization
Contact information
Practice address
16063 HWY 69 SOUTH, MOUNDVILLE, AL 35474
(205) 371-2267
Mailing address
PO BOX 687, MOUNDVILLE, AL 35474
(205) 371-2267
(205) 371-9031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8780
AL
363L00000X
Nurse Practitioner
1079822
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529916560
—
AL
Enumeration date
02/01/2008
Last updated
02/01/2008
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