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General NPI Number Information
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NPI Number | 1790774461
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Entity Type | Organization
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Legal Business Name | SUMMIT FAMILY PHYSICIANS INC
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1010 SUMMITT SQ
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3400
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Country | US
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Telephone | 513-424-0122
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Fax | 513-424-3863
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Provider Business Mailing Address
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Address Line | 1010 SUMMITT SQ
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3400
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Country | US
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Telephone | 513-424-0122
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Fax | 513-424-3863
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PATTI EATON
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Credential |
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Telephone | 513-424-0122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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