Provider Demographics
NPI:1174096580
Name:SUMMIT MEDICAL GROUP, INC
Entity type:Organization
Organization Name:SUMMIT MEDICAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AVP - REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-655-2583
Mailing Address - Street 1:1360 DOLWICK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018
Mailing Address - Country:US
Mailing Address - Phone:859-344-5555
Mailing Address - Fax:859-344-5552
Practice Address - Street 1:8726 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-8550
Practice Address - Country:US
Practice Address - Phone:859-647-2900
Practice Address - Fax:859-647-0140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMT MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-08
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care