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General NPI Number Information
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NPI Number | 1942408554
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Entity Type | Organization
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Legal Business Name | SUMMIT SURGICAL CONSULTANTS PLLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 340 PEAK 1 DR
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-668-5858
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5297
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City | FRISCO
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State | CO
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Zip | 80443-5297
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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 | TREASURER
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Name | DR. JAMES EVES GEDDES
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Credential | MD
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Telephone | 970-668-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 22112
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License Number State | CO
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