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General NPI Number Information
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NPI Number | 1609776483
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Entity Type | Organization
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Legal Business Name | SUMMIT SURGICAL ASSISTANT LLC
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 1111 E MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85006-2612
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Country | US
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Telephone | 602-839-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41340
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City | PHOENIX
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State | AZ
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Zip | 85080-1340
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WILL THOMPSON
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Credential |
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Telephone | 623-320-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical 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 | 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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