Healthcare Provider Details

I. General information

NPI: 1639033962
Provider Name (Legal Business Name): SUMMIT SURGICAL ASSIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3929 E BELL RD
PHOENIX AZ
85032-2112
US

IV. Provider business mailing address

1902 W UNION HILLS DR # 41340
PHOENIX AZ
85027-5984
US

V. Phone/Fax

Practice location:
  • Phone: 623-320-0660
  • Fax: 623-320-0670
Mailing address:
  • Phone: 480-773-1803
  • Fax: 623-320-0670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

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