Healthcare Provider Details

I. General information

NPI: 1659251817
Provider Name (Legal Business Name): CHRISTOPHER A SKABELUND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E SOUTHERN AVE STE 1020
TEMPE AZ
85282-8009
US

IV. Provider business mailing address

1400 E SOUTHERN AVE
TEMPE AZ
85282-5691
US

V. Phone/Fax

Practice location:
  • Phone: 480-869-6209
  • Fax:
Mailing address:
  • Phone: 480-869-6209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number161602
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number161602
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number161602
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: