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General NPI Number Information
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NPI Number | 1205623113
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Entity Type | Organization
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Legal Business Name | SKYWAY DEVELOPMENT LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2021 MORRIS AVE STE 300
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City | BIRMINGHAM
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State | AL
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Zip | 35203-4184
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Country | US
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Telephone | 205-792-0249
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 MORRIS AVE STE 300
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City | BIRMINGHAM
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State | AL
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Zip | 35203-4184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JACOB TUBBS
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Credential |
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Telephone | 205-792-0249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number |
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License Number State |
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