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General NPI Number Information
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NPI Number | 1306658703
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Entity Type | Organization
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Legal Business Name | SUMMIT SURGICAL, LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1818 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-1106
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Country | US
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Telephone | 620-662-6000
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Fax | 620-663-4803
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Provider Business Mailing Address
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Address Line | 1818 E 23RD AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-1106
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Country | US
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Telephone | 620-662-6000
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Fax | 620-663-4803
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Authorized Official
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Title or Position | COO
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Name | CHERISE BROWN
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Credential |
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Telephone | 620-620-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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