Provider Demographics
NPI:1568629491
Name:MICHAEL J SEKOSKY
Entity Type:Organization
Organization Name:MICHAEL J SEKOSKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-837-2240
Mailing Address - Street 1:3815 E BELL RD
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2122
Mailing Address - Country:US
Mailing Address - Phone:602-569-2321
Mailing Address - Fax:602-569-6220
Practice Address - Street 1:3815 E BELL RD
Practice Address - Street 2:STE 4300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:480-837-2240
Practice Address - Fax:480-836-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0320213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ39496603Medicaid
AZAZ1830OtherHEALTH NET
AZAZ1830OtherHEALTH NET