Provider Demographics
NPI:1124221213
Name:SKIPPER, JONI BYRD (MD)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:BYRD
Last Name:SKIPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ISAAC G LAROCHE DR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2171
Mailing Address - Country:US
Mailing Address - Phone:912-921-5900
Mailing Address - Fax:
Practice Address - Street 1:111 ISAAC G LAROCHE DR
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2171
Practice Address - Country:US
Practice Address - Phone:912-921-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78644207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology