Summit Surgical Consultants PC

Organization Active NPI Surgery Physician · Show Low, AZ

NPI 1487625919 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1487625919
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
SUMMIT SURGICAL CONSULTANTS PC
Practice address
5171 Cub Lake Rd
Suite 390
Show Low, AZ 85901-7888
Phone
(928) 532-5463
Fax
(928) 532-8474
NPI assigned
Feb 1, 2006
Organization subpart
No

Authorized official

Name
Michael Tieman, MD
Title
Owner
Phone
(928) 532-5463

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

5448 Highway 260
Ste 200
Lakeside, AZ 85929

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208600000X Yes

Addresses

Primary practice location

5171 Cub Lake Rd
Suite 390
Show Low, AZ 85901-7888

Mailing address

PO Box 1660
Lakeside, AZ 85929-1660
Phone (928) 532-5463

Other providers in Show Low, AZ

All providers in Show Low, AZ · Surgery Physician in Arizona

Sources for this page

Verify at the official NPI Registry.