Healthcare Provider Details

I. General information

NPI: 1932117975
Provider Name (Legal Business Name): SUMMIT SURGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 E 23RD AVE
HUTCHINSON KS
67502
US

IV. Provider business mailing address

1818 E 23RD AVE
HUTCHINSON KS
67502
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-4800
  • Fax: 620-663-4803
Mailing address:
  • Phone: 620-663-4800
  • Fax: 620-663-4803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberS078004
License Number StateKS

VIII. Authorized Official

Name: CHERISE BROWN
Title or Position: COO
Credential:
Phone: 620-662-6000