Healthcare Provider Details

I. General information

NPI: 1124124284
Provider Name (Legal Business Name): PHILIP J STARCESKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 W ORANGE GROVE RD STE 109
TUCSON AZ
85704-1150
US

IV. Provider business mailing address

5055 E BROADWAY BLVD STE A100
TUCSON AZ
85711-3629
US

V. Phone/Fax

Practice location:
  • Phone: 520-751-3675
  • Fax:
Mailing address:
  • Phone: 520-382-1205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23504
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: