Healthcare Provider Details

I. General information

NPI: 1114831419
Provider Name (Legal Business Name): SUMMIT SURGICAL INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2262 E ROSE GARDEN LN
PHOENIX AZ
85024-4497
US

IV. Provider business mailing address

PO BOX 41340
PHOENIX AZ
85080-1340
US

V. Phone/Fax

Practice location:
  • Phone: 623-320-0660
  • Fax:
Mailing address:
  • Phone: 623-320-0660
  • Fax: 623-320-0670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRETT MCLAUGHLIN
Title or Position: COO
Credential:
Phone: 480-773-1803