Healthcare Provider Details

I. General information

NPI: 1770363467
Provider Name (Legal Business Name): EAGLE-SUMMIT FOOT & ANKLE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 SUMMIT BLVD UNIT 15
FRISCO CO
80443-5882
US

IV. Provider business mailing address

PO BOX 5260
AVON CO
81620-5260
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-4565
  • Fax: 970-668-4566
Mailing address:
  • Phone: 888-453-0080
  • Fax: 224-732-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JULEE ANN MYERS
Title or Position: CREDENTIALING SUPERVISOR
Credential:
Phone: 678-902-0457