Provider Demographics
NPI:1568248912
Name:SKELTON PEDIATRICS
Entity Type:Organization
Organization Name:SKELTON PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:SKELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-546-4743
Mailing Address - Street 1:437 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5713
Mailing Address - Country:US
Mailing Address - Phone:256-546-4743
Mailing Address - Fax:
Practice Address - Street 1:104 W ALABAMA AVE STE B
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-1655
Practice Address - Country:US
Practice Address - Phone:256-891-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty