Basic Information
Provider Information
NPI: 1366503161
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHALESKY
FirstName: HARLEY
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7441 E CALLE TOLUCA
Address2:  
City: TUCSON
State: AZ
PostalCode: 857103745
CountryCode: US
TelephoneNumber: 5207514104
FaxNumber:  
Practice Location
Address1: 2174 W OAK AVE
Address2:  
City: DOUGLAS
State: AZ
PostalCode: 856076003
CountryCode: US
TelephoneNumber: 5203647931
FaxNumber: 5203642551
Other Information
ProviderEnumerationDate: 12/13/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X32646AZY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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