Healthcare Provider Details

I. General information

NPI: 1063409449
Provider Name (Legal Business Name): MICHAEL J SEKOSKY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11046 N SAGUARO BLVD SUITE 2
FOUNTAIN HILLS AZ
85268-5537
US

IV. Provider business mailing address

11046 N SAGUARO BLVD SUITE 2
FOUNTAIN HILLS AZ
85268-5537
US

V. Phone/Fax

Practice location:
  • Phone: 480-837-2240
  • Fax: 480-836-8566
Mailing address:
  • Phone: 480-837-2240
  • Fax: 480-836-8566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0320
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: