| Name: | Catherine A. Skinner, MD, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 07 Apr 2006 (19 years ago) |
| Date of dissolution: | 09 Dec 2019 |
| Entity Number: | 000-477-445 |
| Register Number: | 000477445 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | NORTHPORT, AL |
| Registered Office Street Address: | 4808 LEEWARD AVENORTHPORT, AL 35473 |
| Registered Office Street Address ZIP Code: | 35473 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154543809 | 2007-05-03 | 2008-07-01 | PO BOX 1656, NORTHPORT, AL, 354766656, US | 809 UNIVERSITY BLVD E, TUSCALOOSA, AL, 354012029, US | |||||||||||||||||||||||||||||||
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| Phone | +1 205-344-3973 |
Authorized person
| Name | CATHERINE A SKINNER |
| Role | OWNER |
| Phone | 2053443973 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 24177 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207VX0000X - Obstetrics Physician |
| License Number | 24177 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529931960 |
| State | AL |
| Name | Role |
|---|---|
| SKINNER, CATHERINE A | Agent |
| Name | Role |
|---|---|
| SKINNER, CATHERINE A | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
