Provider Demographics
NPI:1275726135
Name:SULKOSKY, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:SULKOSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10040 E HAPPY VALLEY RD
Mailing Address - Street 2:VILLA 1034
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-2395
Mailing Address - Country:US
Mailing Address - Phone:480-419-1646
Mailing Address - Fax:
Practice Address - Street 1:10040 E HAPPY VALLEY RD
Practice Address - Street 2:VILLA 1034
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-2395
Practice Address - Country:US
Practice Address - Phone:480-419-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11537207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93882Medicare UPIN