Provider Demographics
NPI:1649833906
Name:SKINNER, CRYSTAL HEWITT (MD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:HEWITT
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5005 OSCAR BAXTER DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-3698
Mailing Address - Country:US
Mailing Address - Phone:205-343-2225
Mailing Address - Fax:205-343-7825
Practice Address - Street 1:5005 OSCAR BAXTER DR
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3698
Practice Address - Country:US
Practice Address - Phone:205-343-2225
Practice Address - Fax:205-343-7825
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.42027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1649833906Medicaid