Healthcare Provider Details

I. General information

NPI: 1164870895
Provider Name (Legal Business Name): SUMMIT ORTHOPEDICS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 EAGAN WOODS DRIVE STE 300
EAGAN MN
55121-1466
US

IV. Provider business mailing address

710 COMMERCE DR STE 200
WOODBURY MN
55125-4925
US

V. Phone/Fax

Practice location:
  • Phone: 651-968-5215
  • Fax: 651-730-3601
Mailing address:
  • Phone: 651-968-5215
  • Fax: 651-730-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateMN

VIII. Authorized Official

Name: BECKIE HINES
Title or Position: DIRECTOR OF SURGERY CENTERS
Credential:
Phone: 651-968-5438