Healthcare Provider Details

I. General information

NPI: 1306032347
Provider Name (Legal Business Name): JONATHAN SKIRKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N CAMPBELL AVE
TUCSON AZ
85724-0001
US

IV. Provider business mailing address

PO BOX 245074
TUCSON AZ
85724-5074
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-1000
  • Fax:
Mailing address:
  • Phone: 520-626-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number9368064-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: