Healthcare Provider Details

I. General information

NPI: 1942099684
Provider Name (Legal Business Name): SUMMIT HIP AND KNEE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 N 20TH ST UNIT 10249
PHOENIX AZ
85064-6013
US

IV. Provider business mailing address

PO BOX 41340
PHOENIX AZ
85080-1340
US

V. Phone/Fax

Practice location:
  • Phone: 480-773-1803
  • Fax:
Mailing address:
  • Phone: 480-773-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

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