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Individual

DR. JONATHAN L. SKINNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
105 PROFESSIONAL LN, DOTHAN, AL 36303-3875
(334) 699-0060
(334) 699-0061
Mailing address
105 PROFESSIONAL LN, DOTHAN, AL 36303-3875
(334) 699-0060
(334) 699-1018

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18574
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000097074
AL BLUECROSS BLUESHIELD #
AL
05
135159
AL
Enumeration date
06/15/2005
Last updated
05/24/2022
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