Healthcare Provider Details

I. General information

NPI: 1811253677
Provider Name (Legal Business Name): BRITTANY SUMMER PANICO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY SUMMER WILLIAMS DO

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 E BASELINE RD STE 425
GILBERT AZ
85234-0049
US

IV. Provider business mailing address

2451 E BASELINE RD STE 425
GILBERT AZ
85234-0049
US

V. Phone/Fax

Practice location:
  • Phone: 480-494-2770
  • Fax: 480-494-2771
Mailing address:
  • Phone: 480-494-2770
  • Fax: 480-494-2771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number008453
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number8242
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: