Provider Demographics
NPI:1205851888
Name:SEYKORA, JOHN T (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:SEYKORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CURIE BLVD
Mailing Address - Street 2:1011 BRB
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4863
Mailing Address - Country:US
Mailing Address - Phone:215-662-2597
Mailing Address - Fax:215-349-8339
Practice Address - Street 1:421 CURIE BLVD
Practice Address - Street 2:1011 BRB
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4863
Practice Address - Country:US
Practice Address - Phone:215-662-2597
Practice Address - Fax:215-349-8339
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061274L207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017430100001Medicaid
PA0017430100001Medicaid
PA024856Medicare PIN