Provider Demographics
NPI:1831107218
Name:ERSKINE, THOMAS DONALD (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DONALD
Last Name:ERSKINE
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 1:37818 N 17TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-9532
Mailing Address - Country:US
Mailing Address - Phone:623-465-2853
Mailing Address - Fax:
Practice Address - Street 1:30012 N CAVE CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5833
Practice Address - Country:US
Practice Address - Phone:480-528-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35463208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ126923Medicaid
AZZ141309Medicare PIN
I60994Medicare UPIN
111166Medicare Oscar/Certification