Healthcare Provider Details

I. General information

NPI: 1275137192
Provider Name (Legal Business Name): SUMMIT ORTHOPEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 11/23/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 SCHOOL ROAD SUITE 100
FRISCO CO
80443
US

IV. Provider business mailing address

660 GOLDEN RIDGE RD STE 250
GOLDEN CO
80401-9541
US

V. Phone/Fax

Practice location:
  • Phone: 970-262-7400
  • Fax:
Mailing address:
  • Phone: 303-233-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK J CONKLIN
Title or Position: PRESIDENT
Credential:
Phone: 303-274-7321