Vital Physicians PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

51880 Issued in AZ

Legal business name

VITAL PHYSICIANS PLLC

Practice address

520 Rose LN
Wickenburg, AZ 85390-1447

Phone

(702) 453-3799

Fax

(702) 453-5741

NPI assigned

Jun 16, 2016

Last updated

Nov 15, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jon J Skalecki, M.D.

Title

Sole Owner

Phone

(401) 241-7723

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1720438161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 N 90TH ST STE 102-557",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585040",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "SKALECKI",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "401-241-7723",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "51880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.