Provider Demographics
NPI:1760878136
Name:SKANES, HEATHER D (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:SKANES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:D
Other - Last Name:SKANES-DEVOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 TUSCALOOSA AVE SW STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1424
Mailing Address - Country:US
Mailing Address - Phone:205-291-3058
Mailing Address - Fax:
Practice Address - Street 1:401 TUSCALOOSA AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1424
Practice Address - Country:US
Practice Address - Phone:205-291-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38420207V00000X
390200000X
ALMD38420207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program