MEDICARE: JAMES ALAN SIELSKI DO

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	207Q00000X	Family Medicine Physician	3318	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	080193808	OTHER	AZ	RAILROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124001375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALAN SIELSKI DO

Provider Business Mailing Address
First Line	:	PO BOX 1018
Second Line	:
City	:	GANADO
State	:	AZ
Zip	:	86505-1018
Country	:	US
Telephone Number	:	928-755-3515
Fax Number	:	928-337-3780

Provider Business Practice Location Address
First Line	:	625 NORTH 13TH WEST
Second Line	:
City	:	ST. JOHNS
State	:	AZ
Zip	:	85936
Country	:	US
Telephone Number	:	928-337-3705
Fax Number	:	928-337-3780

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/08/2007

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Directions to “ JAMES ALAN SIELSKI DO” Practice Location

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