Provider Demographics
NPI:1063543940
Name:MICHAEL J SEKOSKY
Entity type:Organization
Organization Name:MICHAEL J SEKOSKY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-957-8726
Mailing Address - Street 1:11046 N SAGUARO BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-5537
Mailing Address - Country:US
Mailing Address - Phone:602-957-8726
Mailing Address - Fax:602-955-9279
Practice Address - Street 1:11046 N SAGUARO BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-5537
Practice Address - Country:US
Practice Address - Phone:602-957-8726
Practice Address - Fax:602-955-9279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0915040001Medicare NSC