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1710131511

NPI Code Detail

MEDICARE: ANDREW JACOB SKABELUND MD

MEDICARE: ANDREW JACOB SKABELUND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	Q1909	TX
2	207R00000X	Internal Medicine Physician	57.015588	OH
3	207RP1001X	Pulmonary Disease Physician	01068141A	IN
4	207R00000X	Internal Medicine Physician	01068141A	IN

General Provider Information

NPI Number	:	1710131511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW JACOB SKABELUND MD

Provider Business Mailing Address
First Line	:	619 S FLEISHEL AVE STE 100
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-2004
Country	:	US
Telephone Number	:	903-606-2299
Fax Number	:	903-606-2838

Provider Business Practice Location Address
First Line	:	619 S FLEISHEL AVE STE 100
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-2004
Country	:	US
Telephone Number	:	903-606-2299
Fax Number	:	903-606-2838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	04/22/2026

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Directions to “ ANDREW JACOB SKABELUND MD” Practice Location

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